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The effect of uterine blood supply cutoff during myomectomy
Abdulaziz Alobaid1, Tarek Alqadri, Fatema Serat
1Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. draalobaid@hotmail.com
Background And Objective:
Myomectomy is considered a highly morbid procedure due to the risk of high intraoperative blood loss. Meticulous surgical techniques can reduce operative morbidity. Our aim was to evaluate and compare the intraoperative blood loss between two surgical techniques: 1) the uterine vascular cutoff technique and 2) the classical technique.
Design And Setting:
Retrospective chart review conducted between 1 July 2008 until 30 June 2010 in a tertiary care referral center to compare surgical outcomes of two groups.
Patients And Methods:
The sample included 136 patients: 30 patients had their surgeries performed with the uterine vascular cutoff technique, and the remainder (106 patients) had myomectomies performed with the classical technique. The uterine vascular cutoff technique was performed by the same surgeon for all 30 patients, whereas myomectomy with the classical technique was performed by several gynecologists.
Results:
There was no significant difference between the two groups in parity and operation time; however, patients in the first group had a statistically significant higher mean age (39.1 [7.6] vs 35.8 [6.9] years; P=.025) and, on average, bigger fibroid size by gestational week (20.1 [7.3] vs 17 [5.2] weeks; P=.0094), with standard deviation shown in parentheses. There was a statistically significant lesser drop in hemoglobin concentration among patients in the first group (1.23 [1.2] vs 2.25 [1.4] g/dL; P=.0003), and the postoperative hemoglobin was significantly higher in the first group (10.5 [1.6] vs 9.7 [1.7] g/dL; P=.036). The hospital stay was shorter for patients in the first group (5.8 [1.7] vs 7.1 [2.9] days; P=.031).
Conclusion:
The vascular cutoff technique leads to less intraoperative blood loss without increasing the operative time, patients tolerate this technique very well, and the technique is associated with shorter hospital stay, all of which could contribute to less postoperative morbidity.
Insights
The uterine vascular cutoff technique for myomectomy significantly reduces blood loss and hospital stay compared to the classical technique. This method offers a safer surgical option with improved patient outcomes.
Area of Science:
- Gynecology
- Surgical Innovation
Background:
- Myomectomy can involve substantial intraoperative blood loss, increasing surgical morbidity.
- Meticulous surgical techniques are crucial for reducing operative risks.
Purpose of the Study:
- To compare intraoperative blood loss between the uterine vascular cutoff technique and the classical myomectomy technique.
- To evaluate the safety and efficacy of the uterine vascular cutoff technique.
Main Methods:
- Retrospective chart review of 136 patients undergoing myomectomy between July 2008 and June 2010.
- Comparison of outcomes between 30 patients who underwent the uterine vascular cutoff technique and 106 patients who underwent the classical technique.
Main Results:
- The uterine vascular cutoff technique group showed a significantly lesser drop in hemoglobin (1.23 vs 2.25 g/dL) and higher postoperative hemoglobin (10.5 vs 9.7 g/dL).
- Patients in the uterine vascular cutoff technique group experienced a shorter hospital stay (5.8 vs 7.1 days).
- No significant difference in parity or operation time was observed; however, the cutoff group had higher mean age and larger fibroid size.
Conclusions:
- The uterine vascular cutoff technique results in reduced intraoperative blood loss and shorter hospital stays.
- This technique is well-tolerated by patients and may contribute to decreased postoperative morbidity.
- The uterine vascular cutoff technique offers a promising alternative for safer myomectomy procedures.
