title: The effect of uterine blood supply cutoff during myomectomy.
abstract: OBJECTIVE
  Myomectomy is considered a highly morbid procedure due to the risk of high intraoperative blood loss. Meticulous surgical techniques can reduce operative morbidity. Our aim was to evaluate and compare the intraoperative blood loss between two surgical techniques: 1) the uterine vascular cutoff technique and 2) the classical technique.
  
  
  METHODS
  Retrospective chart review conducted between 1 July 2008 until 30 June 2010 in a tertiary care referral center to compare surgical outcomes of two groups.
  
  
  METHODS
  The sample included 136 patients: 30 patients had their surgeries performed with the uterine vascular cutoff technique, and the remainder (106 patients) had myomectomies performed with the classical technique. The uterine vascular cutoff technique was performed by the same surgeon for all 30 patients, whereas myomectomy with the classical technique was performed by several gynecologists.
  
  
  RESULTS
  There was no significant difference between the two groups in parity and operation time; however, patients in the first group had a statistically significant higher mean age (39.1 [7.6] vs 35.8 [6.9] years; P=.025) and, on average, bigger fibroid size by gestational week (20.1 [7.3] vs 17 [5.2] weeks; P=.0094), with standard deviation shown in parentheses. There was a statistically significant lesser drop in hemoglobin concentration among patients in the first group (1.23 [1.2] vs 2.25 [1.4] g/dL; P=.0003), and the postoperative hemoglobin was significantly higher in the first group (10.5 [1.6] vs 9.7 [1.7] g/dL; P=.036). The hospital stay was shorter for patients in the first group (5.8 [1.7] vs 7.1 [2.9] days; P=.031).
  
  
  CONCLUSIONS
  The vascular cutoff technique leads to less intraoperative blood loss without increasing the operative time, patients tolerate this technique very well, and the technique is associated with shorter hospital stay, all of which could contribute to less postoperative morbidity.
authors: Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. draalobaid@hotmail.com
authors: Abdulaziz
authors: A
authors: Alobaid
authors: Tarek
authors: T
authors: Alqadri
authors: Fatema
authors: F
authors: Serat
authors: Muhammad
authors: M
authors: Riaz
authors: Solaiman
authors: S
authors: Alobaid
authors: Lateefa
authors: L
authors: Aldakhil
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009929:Organ Size; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000098:blood supply / Q000473:pathology / Q000601:surgery