Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures.
OBJECTIVE
Compare blood loss during cold knife conization of the cervix with and without lateral hemostatic sutures in the cervical branches of the uterine arteries.


METHODS
Randomized clinical trial.


METHODS
Hospital de Clínicas de Porto Alegre (HCPA).


METHODS
102 patients that underwent cold knife conization.


METHODS
Women that underwent cold knife conization of the cervix were randomized to undergo the procedure with or without lateral hemostatic sutures.


METHODS



METHODS
blood loss measured in grams.


METHODS
operative time and postoperative intervention. Only the participants were blinded to group assignment.


RESULTS
From March 2009 to August 2012, patients were randomly assigned to one of the study groups. There were no differences in amount of blood loss between patients that underwent the procedure with and without sutures (p = 0.39). Operative time was shorter in the group without suture (p = 0.020). There were no differences in intervention due to bleeding (p = 0.20). Blood loss was greater among menstruating women than for menopausal women (p = 0.011). There were no differences in amount of blood lost between smoking and nonsmoking patients (p = 0.082).


CONCLUSIONS
Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. ClinicalTrials. gov identifier: NCT02184975.
Universidade Federal do Rio Grande do Sul (PPGCM-UFRGS), Porto Alegre, Brazil.
Letícia Rossi
LR
Bueno
Gynecologic Oncology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Marcia
M
Binda
Gynecologic Oncology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Heleusa
H
Monego
Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Roberta Luísa
RL
Scherer
Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Karen Machado
KM
Rolim
Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Alessandra Leal
AL
Bottini
Research and Teaching Institute, Barretos Cancer Hospital, Brazil.
José H T G
JH
Fregnani
Gynecologic Oncology Department, Barretos Cancer Hospital, São Paulo, Brazil. Electronic address: dr.ricardoreis@hotmail.com.
Ricardo
R
dos Reis
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D003080:Cold Temperature; D019092:Conization / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D013536:Suture Techniques; D013537:Sutures; D055988:Uterine Artery / Q000601:surgery*
D006490:Hemostatics
Cervical intraepithelial neoplasia; Cervix; Cold knife conization; Lateral hemostatic sutures; Surgical technique