title: Hemostatic Techniques for Myomectomy: An Evidence-Based Approach.
abstract: Uterine leiomyomas are the most common benign gynecologic tumor. They are also a significant cause of morbidity, necessitating treatments ranging from hormonal suppression to surgical intervention. Myomectomy, the removal of these highly vascular tumors, offers significant quality of life and fertility-sparing benefit for patients affected by uterine leiomyomas but with a risk of substantial intraoperative blood loss. This risk of hemorrhage leads not only an increased transfusion rate but also he need for hysterectomy and other potential operative complications. Numerous medical and surgical techniques have been developed to minimize potentially significant blood loss during abdominal, laparoscopic, and robotic-assisted myomectomies. Combined with judicious preoperative assessment, these techniques substantially enhance patient safety during a myomectomy and outcomes during recovery.
authors: Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: hickmal@ccf.org.
authors: Lisa Caronia
authors: LC
authors: Hickman
authors: Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio.
authors: Alexander
authors: A
authors: Kotlyar
authors: Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors: Shirley
authors: S
authors: Shue
authors: Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio.
authors: Tommaso
authors: T
authors: Falcone
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002045:Bupivacaine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004598:Electrosurgery / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000601:surgery*; D008026:Ligation; D010121:Oxytocin / Q000627:therapeutic use; D011453:Prostaglandins / Q000008:administration & dosage; D011788:Quality of Life; D065287:Robotic Surgical Procedures / Q000379:methods; D013536:Suture Techniques; D014111:Tourniquets; D014148:Tranexamic Acid / Q000627:therapeutic use; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*; D014667:Vasopressins / Q000627:therapeutic use
chemical_list: D006490:Hemostatics; D011453:Prostaglandins; D014667:Vasopressins; D007987:Gonadotropin-Releasing Hormone; D010121:Oxytocin; D014148:Tranexamic Acid; D002045:Bupivacaine; D004837:Epinephrine
keywords: Hemostasis; Leiomyoma; Myomectomy