Minimizing bleeding in laparotomic myomectomy: A comparative study


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Article type :

Original Article

Author :

Abdelfattah M Agameya, Hisham Saleh, Fady Moiety

Volume :

5

Issue :

1

Abstract :

Objective: To compare the effectiveness of pericervical tourniquet versus intra-myometrial injection of epinephrine in reducing blood loss in abdominal myomectomy. Study Design: A prospective analysis, over 1 year. Setting: University hospital’s Gynaecology centre. Subjects & Methodology: A total of 60 patients presenting with mass-matched uterine fibroid(s), and underwent abdominal myomectomy were studied, allocated into 3 groups; 20 patients each. Group 1 (tourniquet group), where a tourniquet was applied at the cervico-uterine junction from the start of surgery. Group 2 (epinephrine group), where intra-myometrial injection of epinephrine was undertaken at surgery. Group 3 (control) myomectomy was done without blood loss-reducing measures. Results: Group 2 showed a significant reduction in blood loss. No difference between groups in terms of need of blood transfusion nor febrile morbidity. Conclusions: Intra-myometrial injection of epinephrine at the start of abdominal myomectomy seems a simple, and effective method to reduce blood loss during surgery and facilitate the enucleation of the myoma.

Keyword :

Tourniquet, Myomectomy, Epinephrine.