Document Detail


The use of torniquet to reduce blood loss at myomectomy.
MedLine Citation:
PMID:  20499747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Fibroids remain the commonest pelvic tumour seen in women with myomectomy being the major form of treatment in our environment. Techniques to minimize blood loss will reduce patient morbidity and the need for blood transfusions. One such technique is the use of a tourniquet during myomectomy operation. This study examines the effectiveness and safety this tourniquet technique. METHOD: A comparative analysis of the blood loss, transfusion rate and the morbidities associated with the use and non-use of a tourniquet during myomectomy operation at Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria was undertaken. The Foley's urethral catheter was adapted as a uterine tourniquet and applied as low as possible at the base of the uterus before enucleating the fibroid masses. RESULT: The patients who had their myomectomy performed with application of a tourniquet [tourniquet group] and those without [no-tourniquet group] were evenly matched for age, parity and presenting symptoms. The overall mean age of patients was 35.7 +/- 6.1 years and parity was 0.40 +/- 1.25. The main presenting symptoms of the patients were lower abdominal mass 65.6%, menorrhagia 38.7%, infertility 33.3%, abdominal pain 19.4% and dysmenorrhoea 14.0%. There was a statistically significant difference [P < 0.001] in mean blood loss for the no-tourniquet group [756.4 +/- 285.7] and the tourniquet group [515.7 +/- 292.8] as well as the mean blood transfusion rate in no-tourniquet group [1.0 units +/- 1.14] and the tourniquet group [0.24 units +/- 0.51]. However there was no significant difference between the two groups with respect to complication profile. CONCLUSION: The Foley's catheter form of tourniquet is cheap, safe, effectively reduces blood loss during myomectomy and significantly reduces transfusion rate while not adding to the complications due to the operation.
Authors:
J I Ikechebelu; C O Ezeama; N J A Obiechina
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Nigerian journal of clinical practice     Volume:  13     ISSN:  1119-3077     ISO Abbreviation:  Niger J Clin Pract     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101150032     Medline TA:  Niger J Clin Pract     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  154-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. jikechebelu@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Loss, Surgical / prevention & control*
Blood Transfusion
Female
Hemostasis, Surgical / instrumentation,  methods*
Hospitals, Teaching
Humans
Leiomyoma / pathology,  surgery*
Morbidity
Nigeria
Tourniquets*
Treatment Outcome
Uterine Neoplasms / pathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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