未经授权:为了减少腹腔镜子宫肌瘤切除术的术中失血,已采用子宫动脉闭塞或临时子宫动脉夹闭。最近,除了这些技术,据报道,临时子宫动脉结扎术是一种新方法,对生育的侵入性影响较小,不需要使用特殊的装置。本研究旨在评估腹腔镜子宫肌瘤切除术中临时子宫动脉结扎术的效果,以最大程度地减少术中失血。
UNASSIGNED:这是妇产科的回顾性病例对照研究,Mizonokuchi大学医院,帝京大学医学院。本研究共纳入264例接受腹腔镜子宫肌瘤切除术的子宫肌瘤患者。我们把病人分成两组,行临时子宫动脉结扎术者(52例)和未结扎术者(212例)比较手术时间,失血量,和其他指标。第二,为了确定影响因素,我们使用多变量分析评估了11个代表性因素对大量失血或延长手术时间的影响.
UNASSIGNED:增加临时子宫动脉结扎,术中失血量减少了大约一半(75.1±73.6mlvs.158.5±233.2ml,p=0.011),但手术时间较长(200.5±46.9minvs.160.1±51.3min,p<0.001)。在264名患者中,25例患者(病例组9/52,对照组16/212)手术时间延长(≥240分钟),24例患者(病例组1/52,对照组23/212)出现大量失血(≥400ml)。在多变量分析中,高体重指数,伴随手术和临时子宫动脉结扎术显示与延长手术时间呈正相关,单个平滑肌瘤的存在呈负相关。伴随手术和大型平滑肌瘤的存在与大量失血呈正相关,和临时子宫动脉结扎术显示负相关性。
UNASSIGNED:通过在腹腔镜子宫肌瘤切除术中进行临时子宫动脉结扎术,可以减少术中失血量,尤其是大型平滑肌瘤患者。然而,因为这个程序延长了手术时间,仍有改进的空间。
UNASSIGNED: To reduce intraoperative blood loss in laparoscopic myomectomy, uterine artery occlusion or temporary uterine artery clipping have been employed. Recently, in addition to these techniques, temporary uterine artery ligation has been reported as a new method that has less invasive effects on fertility and needs no special devices to be used. This
study aimed to evaluate the effect of temporary uterine artery ligation to minimize intraoperative blood loss during laparoscopic myomectomy.
UNASSIGNED: This was a retrospective case-control
study at the department of Obstetrics and Gynaecology, University Hospital Mizonokuchi, Teikyo University School of Medicine. A total of 264 patients with uterine leiomyoma who underwent laparoscopic myomectomy were enrolled in this
study. We divided the patients into two groups, those who underwent temporary uterine artery ligation (52 patients) and those who did not (212 patients) and compared the operation time, blood loss volume, and other indexes. Second, to identify influential factors, we assessed the effects of 11 representative factors on massive blood loss or a prolonged operation time using multivariate analysis.
UNASSIGNED: The intraoperative blood loss volume was decreased by approximately half with the addition of temporary uterine artery ligation (75.1 ± 73.6 ml vs. 158.5 ± 233.2 ml, p = 0.011), but the operation time was longer (200.5 ± 46.9 min vs. 160.1 ± 51.3 min, p < 0.001). Among the 264 patients, 25 patients (9/52 in the case group and 16/212 in the control group) had a prolonged operation time (≥ 240 min), and 24 patients (1/52 in the case group and 23/212 in the control group) experienced massive blood loss (≥ 400 ml). In the multivariate analysis, high body mass index, concomitant surgery and temporary uterine artery ligation showed a positive association with a prolonged operative time, and the presence of single leiomyoma showed a negative association. Concomitant surgery and the presence of large leiomyoma showed a positive association with massive blood loss, and temporary uterine artery ligation showed a negative association.
UNASSIGNED: By performing temporary uterine artery ligation during laparoscopic myomectomy, the volume of intraoperative blood loss could be decreased, especially in patients with large leiomyomas. However, because this procedure prolongs the operation time, there is still room for improvement.