Absorbable Cervical Tourniquet at Open Myomectomy: A Pilot Study
2004; Mary Ann Liebert, Inc.; Volume: 20; Issue: 2 Linguagem: Inglês
10.1089/1042406041422253
ISSN1557-7724
AutoresPeter Scott, Alex Taylor, Wai Yoong, Adam Magos,
Tópico(s)Endometriosis Research and Treatment
ResumoObjective: To assess the effects of vascular occlusion of the uterine arteries with an absorbable cervical tourniquet at open myomectomy. Methods: Twelve women with a large fibroid uterus underwent open myomectomy for surgical management of menorrhagia and pelvic pressure symptoms. All patients had a number-1 polyglactin (absorbable) suture tied around the cervix to occlude the uterine vessels and temporary tourniquets tied around the infundibulopelvic ligaments to occlude the ovarian vessels. Intraoperative blood loss was assessed by suction and swabs, and postoperative loss by surgical drains. Results: The mean age of patients was 40 years (standard deviation 2.4). The median uterine size was equivalent to 19 weeks gestation (range 16–28). An average of 17 fibroids were removed from each patient (range 2–84) weighing 608g (range 220–3030). The average intraoperative blood loss was 840 mL (range 400–1540). Postoperatively, the median loss in the drain at 24 hours was 350 mL (range 65–760). The median drop in day 2 Hb compared to preoperative levels was 2.8 g/dL (range 1.5–5.5). Two patients were transfused 2 units and 3 units respectively. Conclusions: The use of a delayed absorbable vascular tourniquet around the cervix to occlude the uterine vessels at open myomectomy appears to be safe. Theoretically, such a tourniquet may reduce not only intraoperative bleeding but also postoperative oozing from the uterine incision(s).
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