Effects of Three Strategies for Hemostasis in Laparoscopic-Assisted Vaginal Myomectomy

doi:10.3877/cma.j.issn.1673-5250.2012.04.017

Objective

To explore the clinical effects of three strategies for hemostasis in laparoscopic-assisted vaginal myomectomy.

Methods

From February 2005 to August 2010, a total of 36 women with hysteromyoma who would accept laparoscopic-assisted vaginal myomectomy were included in the study, and were divided randomly into uterine artery occlusion group(n=12), pituitrin group(n=12) and bipolar coagulation group(n=12) based on different strategies for hemostasis during surgery. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of People's Hospital of Macheng. Informed consent was obtained from all participants. There had no significance difference among three groups in ages, pieces and diameters of hysteromyomas, and severity of menstruation irregular etc.(P>0.05).

Results

There had no significant difference among three groups in operation duration, postoperative body temperature at 72 h, and anal exhaust time(P>0.05). There had significant differences among three groups in intraoperative blood loss volume and postoperative drainage volume(P<0.05). there had no significant difference among three groups in hospital stay and its costs(P>0.05).

Conclusions

Uterine artery occlusion is the best intraoperative hemostasis strategy in laparoscopic-assisted vaginal myomectomy. In laparoscopic-assisted vaginal myomectomy, can select others technologies and strategies to promote hemostasis in intraoperative.

Key words: laparoscopic-assisted vaginal myomectomy, uterine artery occlusion, pituitrin, hemostasis

表1 3组患者一般情况比较(±s)

Table 1 Comparison of general clinical data among three groups(±s)

组别	平均年龄(岁)	肿瘤直径(cm)	浆膜下肌瘤数(个)	肌壁间肌瘤数(个)
子宫动脉阻断组	34.6±5.2	5.9±2.1	1.2±0.5	2.2±0.7
垂体后叶素组	35.0±4.9	6.1±1.9	1.1±0.4	2.3±0.6
双极电凝组	34.8±5.1	6.1±2.2	1.2±0.5	2.2±0.8
P	>0.05	>0.05	>0.05	>0.05

表1 3组患者一般情况比较(±s)

Table 1 Comparison of general clinical data among three groups(±s)

组别	平均年龄(岁)	肿瘤直径(cm)	浆膜下肌瘤数(个)	肌壁间肌瘤数(个)
子宫动脉阻断组	34.6±5.2	5.9±2.1	1.2±0.5	2.2±0.7
垂体后叶素组	35.0±4.9	6.1±1.9	1.1±0.4	2.3±0.6
双极电凝组	34.8±5.1	6.1±2.2	1.2±0.5	2.2±0.8
P	>0.05	>0.05	>0.05	>0.05

表2 3组术中及术后相关指标比较(±s)

Table 2 Comparison of related indicators before and after surgery among three groups(±s)

组别	手术时间(min)	术中出血量(mL)	术后引流量(mL)	术后72h体温(℃)	排气时间(h)
子宫动脉阻断组	113.4±30.5	55.5±19.1	66.4±8.4	37.2±0.4	22.0±4.9
垂体后叶素组	108.7±32.9	78.4±24.2^a	85.1±6.3^a	36.9±0.3	21.5±5.1
双极电凝组	104.9±28.7	159.5±14.6^b	132.4±10.7^b	36.9±0.5	22.1±4.8

表2 3组术中及术后相关指标比较(±s)

Table 2 Comparison of related indicators before and after surgery among three groups(±s)

组别	手术时间(min)	术中出血量(mL)	术后引流量(mL)	术后72h体温(℃)	排气时间(h)
子宫动脉阻断组	113.4±30.5	55.5±19.1	66.4±8.4	37.2±0.4	22.0±4.9
垂体后叶素组	108.7±32.9	78.4±24.2^a	85.1±6.3^a	36.9±0.3	21.5±5.1
双极电凝组	104.9±28.7	159.5±14.6^b	132.4±10.7^b	36.9±0.5	22.1±4.8

表3 3组住院时间及费用比较(±s)

Table 3 Comparison of hospital stay and its costs among three groups(±s)

组别	住院时间(d)	住院费用(元)
子宫动脉阻断组	3.5±0.4	6285.6±568.4
垂体后叶素组	3.7±0.6^a	6237.9±609.5^a
双极电凝组	3.5±0.6^b	6244.8±587.5^b

表3 3组住院时间及费用比较(±s)

Table 3 Comparison of hospital stay and its costs among three groups(±s)

组别	住院时间(d)	住院费用(元)
子宫动脉阻断组	3.5±0.4	6285.6±568.4
垂体后叶素组	3.7±0.6^a	6237.9±609.5^a
双极电凝组	3.5±0.6^b	6244.8±587.5^b

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