Document Detail


Preoperative embolization or ligature of the uterine arteries in preparation for conservative uterine fibroma surgery.
MedLine Citation:
PMID:  20726700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy, feasibility and morbidity of two preparation techniques for conservative uterine myoma surgery: temporary embolization and temporary surgical ligature of the uterine arteries. DESIGN: Retrospective study. SETTING: Gynecological Surgery and Interventional Radiology departments, Centre Hospitalier Universitaire of Dijon, France. POPULATION: A total of 100 women undergoing myomectomy between 2000 and 2008. METHODS: Three groups were constituted: (1) no preparation (43 patients), (2) uterine artery embolization (UAE) (30 patients) and (3) temporary surgical ligature of the uterine arteries (SLUA) (27 patients). The choice of technique depended on the number, size and topography of the fibromas. MAIN OUTCOMES MEASURES: Quantification of peroperative blood loss, delta hemoglobin, complications, subsequent fertility. RESULTS: Blood loss and delta hemoglobin were both lower in group 2 (p = 0.026 and p = 0.0002) and in group 3 (p = 0.048 and p = 0.001), respectively, than in group 1. The two preparation techniques were efficient. SLUA increased the duration of the operation (p < 0.0001). Hospitalization was longer following UAE (p = 0.0001). The rate of complications was 16.3, 23.3 and 3.7%, and of synechiae 9.3, 13.3 and 0% for groups 1, 2 and 3, respectively. The number of pregnancies was 8, 5 and 6 after a mean postoperative period of 5.6, 4.3 and 3.9 years, respectively. CONCLUSION: Both UAE and SLUA for myomectomy are feasible, reproducible and effective techniques for reducing peroperative blood loss. Use of these techniques must be generalized in patients with a high risk of hemorrhage, but may be compatible with subsequent fertility.
Authors:
Hervé Tixier; Julie Grevoul; Romaric Loffroy; Juliette Lauferon; Boris Guiu; William Mutamba; Laurence Filipuzzi; Jean Pierre Cercueil; Serge Douvier; Denis Krause; Paul Sagot
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1310-5     Citation Subset:  IM    
Affiliation:
Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon cedex, France. herve_tixier@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Feasibility Studies
Female
Humans
Leiomyoma / surgery,  therapy*
Ligation
Middle Aged
Retrospective Studies
Treatment Outcome
Uterine Artery / surgery*
Uterine Artery Embolization*
Uterine Neoplasms / surgery,  therapy*

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