Medicina (Nov 2023)

The Efficiency of a Uterine Isthmus Tourniquet in Minimizing Blood Loss during a Myomectomy—A Prospective Study

  • Ligia Balulescu,
  • Simona Brasoveanu,
  • Marilena Pirtea,
  • Oana Balint,
  • Aurora Ilian,
  • Dorin Grigoras,
  • Flavius Olaru,
  • Madalin-Marius Margan,
  • Alexandru Alexandru,
  • Laurentiu Pirtea

DOI
https://doi.org/10.3390/medicina59111979
Journal volume & issue
Vol. 59, no. 11
p. 1979

Abstract

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Background and Objectives: The objective of this study was to assess the effectiveness of using a peri-cervical tourniquet in reducing blood loss during a laparoscopic myomectomy. Materials and Methods: This prospective study evaluated the impact of performing a concomitant tourniquet placement during a laparoscopic myomectomy (LM). A total of 60 patients were randomly allocated to one of two groups: 30 patients who underwent an LM with a tourniquet placement (the TLM group) and 30 patients who benefited from a standard LM (the SLM group). This study’s main objective was to evaluate the impact of tourniquet use on perioperative blood loss, which is quantified as the difference in the pre- and postoperative hemoglobin levels (Delta Hb) and the postoperative blood transfusion rate. Results: The mean Delta Hb was statistically lower in the TLM group compared to the SLM group: 1.38 g/dL vs. 2.41 g/dL (p p = 0.02). All four patients that required a blood transfusion were from the SLM group. On average, the peri-cervical tourniquet fastening time was 10.62 min (between 7 and 15 min), with no significant impact on the overall operative time: 98.50 min for the TLM group compared to 94.66 min for the SLM group. Conclusions: Fastening a tourniquet during a laparoscopic myomectomy is a valuable technique to effectively control intraoperative bleeding and enhance surgical outcomes.

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