Comparison of the effects of the ligation of ascending branches of bilateral arteria uterina with tourniquet method on the intra-operative and post-operative hemorrhage in abdominal myomectomy cases

SAPMAZ E., Çelik H.

European Journal of Obstetrics and Gynecology and Reproductive Biology, cilt.111, sa.1, ss.74-77, 2003 (SCI-Expanded, Scopus)

Özet

Objective: To compare the effects of ligation of the ascending branches of the uterine artery and tourniquet methods intra-operative and post-operative hemorrhage during abdominal myomectomy. Methods: Fifty-one cases with symptomatic myoma uteri were prospectively, randomly assigned to two single blind groups. Myomectomy was performed in Group 1 (n=26) by bilateral ligation of the ascending branches of the uterine artery and in Group 2 (n=25) by the intra-operative tourniquet method. Mann-Whitney U, Wilcoxon Rank and χ 2 tests were used in the comparison of the data. Spearman correlation analysis was used to determine the correlation between myoma enucleation, operation duration and blood loss (r s , P, n). Results: Operation time, number of removed myoma nuclei, (P>0.05, Mann-Whitney U test), and febrile morbidity were similar in the two groups (P>0.05, χ 2 test). Intra-operative blood loss was lower in Group 1 (P<0.05, Mann-Whitney U test). In three cases from Group 2 post-operative hemorrhage occurred, and the laparotomy and bilateral ligation of the internal iliac arteries were performed in these cases. There was a positive correlation among myoma enucleation, operation duration and blood loss (r s =0.7, P=0.001, n=51). Conclusions: Intra-operative blood loss is lower with bilateral ligation of the ascending branches of the uterine artery during myomectomy. The effect of ligation on hemorrhage continues in the post-operative period. © 2003 Elsevier Ireland Ltd. All rights reserved.