title: Preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during abdominal myomectomy.
abstract: OBJECTIVE
  To compare the effectiveness of preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during myomectomy.
  
  
  METHODS
  A total of 103 patients undergoing myomectomy were randomly allocated to undergo preliminary uterine artery ligation (52 patients) or pericervical tourniquet (51 patients). The primary outcome measure was estimated blood loss. Secondary outcomes included duration of the operation, duration of hospital stay, postoperative hemoglobin, and the need for postoperative analgesia.
  
  
  RESULTS
  Operative blood loss was significantly less with uterine artery ligation compared with tourniquet (433.80+/-285.21 vs 823.23+/-237.33mL, P<0.001). The mean duration of the operation was lower in the uterine artery ligation group compared with the tourniquet group (50.5+/-8.7 vs 76.3+/-9.4 minutes, P<0.001). Postoperative hospital stay was significantly shorter in the uterine artery ligation group compared with the tourniquet group (4.1+/-0.1 vs 5.1+/-0.2 days; P<0.001). Postoperative hemoglobin concentrations and the need for postoperative analgesia were higher in the uterine artery ligation group (P=0.012 and P<0.001, respectively).
  
  
  CONCLUSIONS
  Uterine artery ligation was more effective than pericervical tourniquet as a preliminary step in reducing blood loss during abdominal myomectomy.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt. adelsaadhelal@yahoo.com
authors: Adel Saad
authors: AS
authors: Helal
authors: El-Said
authors: el-S
authors: Abdel-Hady
authors: Ehsan
authors: E
authors: Refaie
authors: Maged
authors: M
authors: El Shamy
authors: Raafat Abd
authors: RA
authors: El Fattah
authors: Abd El Magied
authors: Ael M
authors: Mashaly
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008026:Ligation; D009215:Myometrium / Q000601:surgery; D011446:Prospective Studies; D014111:Tourniquets; D055988:Uterine Artery / Q000601:surgery*; D014594:Uterine Neoplasms / Q000601:surgery*