Evaluation of loop ligation of larger myoma pseudocapsule combined with vasopressin on laparoscopic myomectomy.

摘要

OBJECTIVE: To study the effects of reducing hemorrhage by loop ligation of larger myoma pseudocapsules combined with vasopressin on laparoscopic myomectomy (LM). DESIGN: Prospective controlled clinical trial. SETTING: Sheng Jing Hospital, China Medical University. PATIENT(S): A total of 105 women with symptomatic single or multiple larger myomas (diameter 6-18 cm) in need of surgical intervention, who wished to retain their uteri, were randomly divided into three groups in our hospital from January 2006 to January 2008: A) loop ligation combined with vasopressin; B) vasopressin alone; and C) neither loop ligation nor vasopressin. All patients were treated by LM. Each group included 35 cases. INTERVENTION(S): Loop ligation of larger myoma (6-18 cm) pseudocapsule combined with vasopressin before thoroughly enucleating the myoma. MAIN OUTCOME MEASURE(S): Operating time, blood loss, blood transfusion, postoperative stay in hospital, symptom improvement. RESULT(S): Average blood loss, postoperative stay in hospital, number of conversions to laparotomy, and need for transfusion because of bleeding during operation in group A were significantly lower than in groups B and C. All patients in group A underwent technically successful laparoscopic operations. CONCLUSION(S): Loop ligation of larger myoma pseudocapsules combined with vasopressin is a safe, effective, and promising new method to reduce bleeding during laparoscopic myomectomy and makes the laparoscopic operations with larger myomas easier.