The impact of bilateral transient occlusion of uterine and utero-ovarian arteries on surgical blood loss during laparoscopic myomectomy: A systematic review and meta-analysis of randomized controlled trials.

Autor: Baradwan S; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Hafedh B; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Himayda S; Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia., Albouq B; Department of Obstetrics and Gynecology, Prince Mohammed Bin Abdulaziz National Guard Hospital, Madinah, Saudi Arabia., Badghish E; Department of Obstetrics and Gynecology, Maternity and Children Hospital, Makkah, Saudi Arabia., Awadh N; Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia., Baradwan A; Department of Obstetrics and Gynecology, Al Salama Hospital, Jeddah, Saudi Arabia., Saleh MM; Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt., Nassef AH; Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt., Elghamry EE; Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt., Alshareef MM; Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt., Hassan AM; Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt., Abdelhakim AM; Kasralainy, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: ahmed.m.rohei@students.kasralainy.edu.eg., Mojahed EM; Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2024 Dec 19; Vol. 305, pp. 241-247. Date of Electronic Publication: 2024 Dec 19.
DOI: 10.1016/j.ejogrb.2024.12.033
Abstrakt: Background: The primary perioperative concern during laparoscopic myomectomy is the risk of significant intraoperative blood loss, which can lead to hypovolemia, necessitate blood transfusion, and result in postoperative anemia. To address this issue, we conducted a systematic review and meta-analysis to assess the impact of temporarily clamping the uterine and utero-ovarian arteries on operative blood loss during laparoscopic myomectomy.
Methods: We conducted a comprehensive search across various databases to identify eligible clinical trials from inception to May 2024, focusing on randomized controlled trials (RCTs). In the intervention group, temporary bilateral clamping of the uterine and utero-ovarian arteries was performed during laparoscopic myomectomy, while the control group underwent laparoscopic myomectomy without arterial clamping. A meta-analysis was carried out on the gathered data using Revman software. The primary outcomes examined were blood loss and change in hemoglobin, with secondary outcomes including operation time and length of hospital stay.
Results: Three RCTs, involving a total of 275 patients, met our inclusion criteria. The intervention group showed significantly lower operative blood loss and a smaller reduction in hemoglobin compared to the control group. There was no notable difference in operation time between the two groups. Moreover, patients in the experimental group experienced a significantly shorter hospitalization duration than those in the control group.
Conclusions: The temporary bilateral occlusion of the uterine and utero-ovarian arteries is an effective method for reducing surgical blood loss, hemoglobin decline, and hospital stay duration during laparoscopic myomectomy. However, additional studies are needed to validate these findings.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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