The aim of study is to compare triple tourniquet vs. single tourniquet to reduce blood loss at open myomectomy.
Single tourniquet is applied to uterine isthmus to occlude uterine arteries. Triple tourniquet is applied to both infundibulopelvic ligaments and uterine isthmus.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
48
Triple tourniquet consist of two tourniquet applied both infundibulopelvic ligaments and one uterine isthmus to occlude the left and right ovarian vessels and to occlude the uterine arteries. For this purpose, a small opening is made in the avascular place of the broad ligament on either side of the uterine isthmus superior to the uterine vessels. A pediatric Foley catheter is threaded through the two holes and tied tightly anteriorly around the cervix at the level of the internal os. Through the same openings in the broad ligament each side a Foley catheter looped around the infundibulopelvic ligament lateral to the fallopian tube and ovary.
Single tourniquet is tourniquet applied uterine isthmus to occlude the uterine arteries. For this purpose, a small opening is made in the avascular place of the broad ligament on either side of the uterine isthmus superior to the uterine vessels. A pediatric Foley catheter is threaded through the two holes and tied tightly anteriorly around the cervix at the level of the internal os.
Atatürk Universitesi Araştırma Hastanesi
Erzurum, Yakutiye, Turkey (Türkiye)
Estimating blood loss at the end of myomectomy
Surgical blood loss will be estimated by sum of the volume of suction fluid and blood loss quantitated by gravimetric method. During surgery, if it is possible, irrigation will not be done, surgical sponge and compress will not be used. * Suction fluid will be measured at the end of operation and volume of irrigation fluid will be subtracted from total suction volume. * Surgical drapes, sponges and towels will be weighted before and just after surgery. The blood loss will be estimated as differences in gram by weighing when 1ml blood supposed as 1 gr.
Time frame: 15 minutes postoperatifly
The amount of transfusions
Erythrocyte transfusions transfusion will be allowed when haemoglobin dropped below 8 g/dL.
Time frame: 7 Days
A change in hemoglobin
Time frame: At baseline and 48 hours after surgery
Volume in drains
Drain will be removed when discharge drops below 50 ml/day
Time frame: 7 days
Anti-Mullerian Hormone levels variation
Anti-Mullerian Hormone levels before and 6 months after surgery
Time frame: 6 weeks
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