[Assessment of different homeostatic methods used in laparoscopic intramural myomectomy].

Abstract

OBJECTIVE:

To explore the safe and effective method of hemostasis in laparoscopic hysteromyomectomy (LM).

METHODS:

Two hundred and eighty women with symptomatic uterine intramural fibroids undergoing LM were assigned to 4 groups, Group A undergoing fibroid pedicle ligation, Group B injected with 12 IU diluted vasopressin around the myoma, Group C injected with 20 IU oxytocin combined with pedicle ligation, and Group D injected with vasopressin combined with pedicle ligation. The operation time, amount of blood loss, operative complications, bowel deflation, post-operative hemoglobin dropping, and length of hospital stay were compared.

RESULTS:

The amounts of blood loss of Groups A and C were (171 +/- 146) ml and (184 +/- 140) ml, both significantly higher than those of Groups B and D [(115 +/- 70) ml and (106 +/- 73) ml, both P < 0.01]. The length of hospital stay of Group D was (2.9 +/- 0.5) d, significantly shorter than those of Groups A, B, and C [(3.1 +/- 0.7) d, (3.6 +/- 0.8) d, and (3.3 +/- 0.7) d, all P < 0.05]. The bowel deflation time of Group D was (20 +/- 6) h, significantly shorter than those of the Groups A, B, and C [(26 +/-) h, (25 +/- 7) h, and (25 +/- 8) h respectively, all P < 0.05]. The post-operative hemoglobin dropping of group D was (1.1 +/- 0.9) g/L, significantly less than those of Groups A, B, and C [(1.5 +/- 1.0), (1.4 +/- 0.8), and (1.2 +/- 0.7) g/L respectively, all P < 0.05].

CONCLUSIONS:

Vasopressin (12 IU) injection around the myoma is a simple, effective, and safe homeostatic procedure during LM. Pedicle ligation can reduce advanced post-operative bleeding post-operation.

• Authors: Xiao-Na Lin, Song-Ying Zhang, Su-Hua Fang, Min-Zhen Wang, Hong-Ying Lou
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 88 Issue 13 Pg. 905-8 (Apr 01 2008) ISSN: 0376-2491 [Print] China
• PMID: 18756957 (Publication Type: English Abstract, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Hemostatics
• Oxytocics
• Vasopressins
• Oxytocin

Topics

• Adult
• Combined Modality Therapy
• Female
• Gynecologic Surgical Procedures (methods)
• Hemostatic Techniques
• Hemostatics (administration & dosage, therapeutic use)
• Humans
• Laparoscopy
• Leiomyoma (therapy)
• Myoma (therapy)
• Oxytocics (administration & dosage, therapeutic use)
• Oxytocin (administration & dosage, therapeutic use)
• Postoperative Hemorrhage (prevention & control)
• Treatment Outcome
• Uterine Neoplasms (therapy)
• Vasopressins (administration & dosage, therapeutic use)