The Use of Vasopressor and Tourniquet to Reduce Hemorrhage during Myomectomy for Uterine Fibroid Removal: A Systematic Review

Open Access Macedonian Journal of Medical Sciences Pub Date : 2024-01-23 DOI:10.3889/oamjms.2024.11786

Suskhan Djusad, Ario Bimo, Annisa Futihandayani

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Abstract

AIM: This review aims to evaluate the efficacy of vasopressin and tourniquet to reduce blood loss during myomectomy for uterine fibroids removal. BACKGROUND: Uterine fibroids and uterine leiomyomata, the most common benign tumors in women, can be difficult for women trying to conceive. Surgical therapy, such as hysterectomy or myomectomy, is one of the main treatment options. Excessive blood loss may occur during the procedure. Clamps or tourniquets around the uterine vessels are commonly used as anti-bleeding precautions during myomectomy. Intra-myometrial injection of vasopressin at the base of the largest fibroids and during hysteroscopic myomectomy is effective in reducing blood loss during laparoscopic myomectomy. METHODS: A literature search and computer-aided comprehensive electronic bibliographic search was performed using PubMed, Science Direct, SCOPUS, and Wiley for studies published from January 1997 to November 2017. RESULTS: Ten studies met the eligibility criteria and were included in this review. Each study assessed and compared the effects of vasopressin to the control group that exerts a hormonal hemorrhagic effect during myomectomy procedures. About 50% of vasopressin hemostatic agents have better outcomes in reducing blood loss. However, the use of both vasopressin and tourniquet simultaneously failed to reduce blood loss. DISCUSSION: Intramyometrial vasopressin injection resulted in a higher efficacy to decrease blood loss during myomectomy. Despite deciding which methods provide the most effective way to decrease blood loss, the two techniques showed excellent outcomes for the quality of the myomectomy procedure itself. CONCLUSION : Hemostatic medications have shown to have positive effects on myomectomy patients. The predicted volume of blood loss significantly decreased by both the mechanical tourniquet approach and the injection of the hormone vasopressin.

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使用血管加压素和止血带减少子宫肌瘤切除术中的出血：系统回顾

目的：本综述旨在评估在子宫肌瘤剔除术中使用血管加压素和止血带以减少失血的效果。子宫切除术或子宫肌瘤剔除术等手术疗法是主要的治疗方法之一。手术过程中可能会失血过多。在子宫肌瘤切除术中，通常会在子宫血管周围使用夹子或止血带作为止血预防措施。在最大子宫肌瘤基底部和宫腔镜子宫肌瘤剔除术中，子宫肌瘤内注射血管加压素可有效减少腹腔镜子宫肌瘤剔除术中的失血量。方法：使用PubMed、Science Direct、SCOPUS和Wiley对1997年1月至2017年11月期间发表的研究进行文献检索和计算机辅助综合电子文献检索。结果：10项研究符合资格标准，被纳入本综述。每项研究都评估并比较了血管加压素与对照组在子宫肌瘤切除术中发挥激素止血作用的效果。约50%的血管加压素止血剂在减少失血方面有更好的效果。讨论：子宫肌层内注射血管加压素能更有效地减少子宫肌瘤切除术中的失血量。结论：止血药物对子宫肌瘤切除术患者有积极作用。机械止血带法和注射血管加压素都能显著减少预计失血量。

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来源期刊

Open Access Macedonian Journal of Medical Sciences Medicine-Medicine (all)

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1225

期刊介绍： Open Access Macedonian Journal of Medical Sciences (OAMJMS) [formerly known as Macedonian Journal of Medical Sciences] is a top-tier open access medical science journal published by the ID Design 2012/DOOEL Skopje, Rajko Zhinzifov No 48, 1000 Skopje, Republic of Macedonia. OAMJMS is an international, modern, general medical journal covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We publish mostly human studies that substantially enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments; and systematic reviews. We aim to promote translation of basic research into clinical investigation, and of clinical evidence into practice. We publish occasional studies in animal models when they report outstanding research findings that are highly clinically relevant. Our audience is the international medical community as well as educators, policy makers, patient advocacy groups, and interested members of the public around the world. OAMJMS is published quarterly online version. The Open Access Macedonian Journal of Medical Sciences (OAMJMS) publishes Medical Informatics, Basic Science, Clinical Science, Case Report, Brief Communication, Public Health, Public Policy, and Review Article from all fields of medicine and related fields. This journal also publishes, continuously or occasionally, the bibliographies of the members of the Society, medical history, medical publications, thesis abstracts, book reviews, reports on meetings, information on future meetings, important events and dates, and various headings which contribute to the development of the corresponding scientific field.