title: Transient occlusion of uterine arteries in laparoscopic uterine surgery.
abstract: OBJECTIVE
  This study was conducted to determine the feasibility and effectiveness of transient occlusion of the uterine arteries (TOUA) during laparoscopic surgery for benign uterine tumors, with preservation of fertility.
  
  
  METHODS
  Patients with uterine myoma or adenomyoma underwent laparoscopic uterine surgery, with or without TOUA, performed by a single surgeon (Y.-S.K.). Surgical outcomes included operative time; occurrence of intraoperative injury of blood vessels, nerves, and pelvic organs; and intraoperative blood loss.
  
  
  RESULTS
  Of the 168 surgical patients included in this study, 144 were enrolled consecutively during the study period, and 24 had undergone adenomectomy before the study period. A total of 104 women (70 with myoma; 34 with adenomyoma) seeking uterine preservation underwent laparoscopic surgery with TOUA for benign uterine tumors. Sixty-four women (40 with myoma; 24 with adenomyoma) underwent surgery without TOUA. The mean total surgical time of the TOUA groups was 74.85 minutes for uterine myoma and 84.09 minutes for uterine adenomyoma. The mean estimated blood loss during laparoscopic myomectomy and adenomyomectomy was less in the TOUA groups than in the non-TOUA groups (109 vs. 203.4 mL in myomectomy, P < .05; 148.1 vs. 158.9 mL in adenomyomectomy; P < .05). Time to perform TOUA was 13.9 minutes in laparoscopic myomectomy and 7.33 minutes in laparoscopic adenomyomectomy. The hospital stay of the TOUA groups was 3.32 days for uterine myoma and 3.82 days for uterine adenomyoma. No intraoperative conversion to laparotomy was necessary, and no major complications occurred during any of the procedures.
  
  
  CONCLUSIONS
  Laparoscopic uterine surgery with TOUA could be a safe and effective surgical method for women with symptomatic benign uterine tumors who wish to preserve fertility.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Yong-Soon
authors.initials: YS
authors.lastname: Kwon
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Roh
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Jun Woo
authors.initials: JW
authors.lastname: Ahn
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Sang-Hun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Catholic University of Korea, Uijeongbu St Mary's Hospital, Uijeungbu-City, Republic of Korea.
authors.forename: Kyong Shil
authors.initials: KS
authors.lastname: Im
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D055988:Uterine Artery / Q000601:surgery*; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Benign uterine tumor; Laparoscopic uterine surgery; Transient occlusion of uterine arteries; Uterus preservation
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