title: Transient occlusion of uterine arteries with endoscopic vascular clip preceding laparoscopic myomectomy.
abstract: BACKGROUND
  To determine whether performing transient occlusion of uterine arteries (TOUA) immediately before laparoscopic myomectomy can reduce intraoperative complications.
  
  
  METHODS
  In a retrospective case-control study, laparoscopic myomectomy with and without TOUA was examined. Data were analyzed from 89 laparoscopic myomectomies performed by a single surgeon (Y.-S. Kwon) at Ulsan University Hospital (Ulsan, Korea) between March 2011 and December 2011. Surgical outcomes included preoperative myoma size, number of myoma, operative time, and operative blood loss.
  
  
  RESULTS
  Forty-nine women underwent laparoscopic myomectomy with TOUA with endoscopic vascular clipping, whereas 40 control patients underwent laparoscopic myomectomy alone. The TOUA group had no case of nerve or vascular injury during the operation time. The mean time of occlusion of both the uterine arteries was 15 minutes. The TOUA group had less mean blood loss during the operation than the group with laparoscopic myomectomy alone (111.9 versus 203.4 mL; P<.001). There were no significant differences in size and number of uterine myomas and intraoperative complications between the two groups. Moreover, there was not even a single case of conversion of laparoscopy to laparotomy in either group.
  
  
  CONCLUSIONS
  TOUA performed immediately before laparoscopic myomectomy facilitated minimally invasive surgery with lower blood loss and no differences in other intraoperative complications.
authors: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
authors: Yong-Soon
authors: YS
authors: Kwon
authors: Da-Young
authors: DY
authors: Jung
authors: Sang-Hun
authors: SH
authors: Lee
authors: Jun Woo
authors: JW
authors: Ahn
authors: Hyun Jin
authors: HJ
authors: Roh
authors: Kyong Shil
authors: KS
authors: Im
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D055988:Uterine Artery; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*