Limei Ji1, Lanying Jin1, Min Hu2. 1. Department of Obstetrics and Gynecology, Jinhua Hospital of Zhejiang University, Jinhua, China. 2. Department of Obstetrics and Gynecology, Jinhua Hospital of Zhejiang University, Jinhua, China. Electronic address: jlm1104@126.com.
Abstract
STUDY OBJECTIVE: To compare the surgical technique of temporary bilateral uterine artery blockage with titanium clips in laparoscopic myomectomy with traditional surgery for uterine myomas to determine efficacy, ability to control bleeding, and recurrence. DESIGN: Randomized, controlled, prospective study (Canadian Task Force classification I). SETTING: Obstetrics and gynecology department in Jinhua Municipal Central Hospital. PATIENTS: Women with symptomatic uterine myoma. INTERVENTIONS:Sixty-four patients with symptomatic uterine myomas were randomly divided into trial (group A, n = 33) and control groups (group B, n = 31). Temporary bilateral uterine artery occlusion and myomectomy were used in group A and laparoscopic myomectomy only in group B. Operative time, perioperative bleeding, follow-up relief of menorrhagia, and recurrence of myomas were evaluated. MEASUREMENTS AND MAIN RESULTS: All patients in this study underwent successful laparoscopic operation without intraoperative complications. Operative time between groups was not significantly different (p = .255 in single-myoma group and p = .811 in multiple-myoma group), blood loss in group A was notably lower than the conventional surgery group (p < .001). At final follow-up (2 years), recurrence rate and menorrhagia symptom relief were not statistically significant (p = .828 and p > .999, respectively). The fertility index of antimüllerian hormone showed no statistical difference between groups preoperatively or at 2 days, 3 months, 6 months, and 1 year postoperatively (p = .086, p = .247, p = .670, p = .753, and p = .857, respectively). CONCLUSION: Temporary bilateral uterine artery occlusion during laparoscopic myomectomy does not increase mean operative time, offers a possible option to reduce blood loss effectively, improves menorrhagia, and does not impact recurrence rate compared with conventional surgery.
RCT Entities:
STUDY OBJECTIVE: To compare the surgical technique of temporary bilateral uterine artery blockage with titanium clips in laparoscopic myomectomy with traditional surgery for uterine myomas to determine efficacy, ability to control bleeding, and recurrence. DESIGN: Randomized, controlled, prospective study (Canadian Task Force classification I). SETTING: Obstetrics and gynecology department in Jinhua Municipal Central Hospital. PATIENTS: Women with symptomatic uterine myoma. INTERVENTIONS: Sixty-four patients with symptomatic uterine myomas were randomly divided into trial (group A, n = 33) and control groups (group B, n = 31). Temporary bilateral uterine artery occlusion and myomectomy were used in group A and laparoscopic myomectomy only in group B. Operative time, perioperative bleeding, follow-up relief of menorrhagia, and recurrence of myomas were evaluated. MEASUREMENTS AND MAIN RESULTS: All patients in this study underwent successful laparoscopic operation without intraoperative complications. Operative time between groups was not significantly different (p = .255 in single-myoma group and p = .811 in multiple-myoma group), blood loss in group A was notably lower than the conventional surgery group (p < .001). At final follow-up (2 years), recurrence rate and menorrhagia symptom relief were not statistically significant (p = .828 and p > .999, respectively). The fertility index of antimüllerian hormone showed no statistical difference between groups preoperatively or at 2 days, 3 months, 6 months, and 1 year postoperatively (p = .086, p = .247, p = .670, p = .753, and p = .857, respectively). CONCLUSION: Temporary bilateral uterine artery occlusion during laparoscopic myomectomy does not increase mean operative time, offers a possible option to reduce blood loss effectively, improves menorrhagia, and does not impact recurrence rate compared with conventional surgery.