Effect of Expansion Technique of Uterine Incision at Caesarean Delivery on the Degree of Intraoperative Blood Loss

2021 ◽  
pp. 88-97
Author(s):  
E. I. Nonye-Enyidah
Keyword(s):  
Blood Loss ◽  
Caesarean Delivery ◽  
Intraoperative Blood Loss ◽  
Uterine Incision ◽  
Expansion Technique

scholarly journals Blood Loss from Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Alaa Elguindy ◽  
Hosam Hemeda ◽  
Mohamed Esmat Shawky ◽  
Mohamed Elsenity ◽  
Medhat Adel Elsayed ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Postoperative Fever ◽  
Longitudinal Incision ◽  
Abdominal Myomectomy ◽  
Randomized Controlled ◽  
Uterine Incision ◽  
Significant Difference

Abstract Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed. Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6). Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

scholarly journals Blood loss from transverse versus longitudinal uterine incision in abdominal myomectomy: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alaa Elguindy ◽  
Hosam Hemeda ◽  
Mohamed Esmat Shawky ◽  
Mohamed Elsenity ◽  
Medhat Adel Elsayed ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Intraoperative Blood Loss ◽  
Postoperative Fever ◽  
Longitudinal Incision ◽  
Abdominal Myomectomy ◽  
Randomized Controlled ◽  
Uterine Incision ◽  
Significant Difference

Abstract Background It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed. Results No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value = 0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value = 0.18), and postoperative fever (4% vs 8.33%, p value = 0.6). Conclusion Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

scholarly journals Blood Loss from Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Alaa Elguindy ◽  
Hosam Hemeda ◽  
Mohamed Esmat Shawky ◽  
Mohamed Elsenity ◽  
Medhat Adel Elsayed ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Postoperative Fever ◽  
Longitudinal Incision ◽  
Abdominal Myomectomy ◽  
Randomized Controlled ◽  
Uterine Incision ◽  
Significant Difference

Abstract Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy.Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed.Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6).Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy.Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

Effect of expansion technique of uterine incision on maternal blood loss in cesarean section

2009 ◽  
Vol 282 (5) ◽  
pp. 475-479 ◽  
Author(s):  
Leila Sekhavat ◽  
Razieh Dehghani Firouzabadi ◽  
Parisa Mojiri
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Maternal Blood ◽  
Uterine Incision ◽  
Expansion Technique

scholarly journals Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Alaa Elguindy ◽  
Hosam Hemeda ◽  
Mohamed Esmat Shawky ◽  
Maii Nawara ◽  
Mohamed Elsenity ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Postoperative Fever ◽  
Longitudinal Incision ◽  
Abdominal Myomectomy ◽  
Randomized Controlled ◽  
Uterine Incision ◽  
Significant Difference

Abstract Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed. Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6). Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

Less Blood Loss by Earlier Oxytocin Infusion in Cesarean Sections? A Randomized Controlled Trial

2020 ◽  
Author(s):  
Taha Takmaz ◽  
Pinar Ozcan ◽  
Osman Sevket ◽  
Ayse Filiz Gokmen Karasu ◽  
Sevde Havva Islek ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Umbilical Cord ◽  
Controlled Trial ◽  
Intraoperative Blood Loss ◽  
Randomized Controlled ◽  
Uterine Incision ◽  
Group I ◽  
Oxytocin Infusion ◽  
The Mean

Abstract Purpose The aim of our study was to evaluate the positive effect of starting an IV oxytocin infusion early before uterine incision on intraoperative blood loss. Methods A total of 101 women between 18–40 years who underwent a primary elective cesarean section (CS) were included in this randomized controlled trial. The patients were divided into two groups. In Group I (n=51), oxytocin infusion was administered immediately after incision of the visceral peritoneum during CS. In Group II (n=50), infusion was administered immediately after clamping the umbilical cord. The primary outcome was the mean volume of blood loss during CS. The secondary outcomes included the mean reduction in hemoglobin and hematocrit levels, need for additional uterotonics and hemostatic uterine sutures, blood transfusion, post-operative pain score, and additional surgical procedures. Results There were statistical significant differences either in the change of the hemoglobin concentration (1.27±0.75 vs.1.74±0.81; p<0.01) or in the change of hematocrit concentration (3.89±2.24 vs. 5.41±2.93; p<0.01). Intraoperative blood loss was significantly lower in Group I when compared to Group II (475.86±150.11 vs. 605.1±203.2; p<0.01). Conclusions Our findings suggest that the starting IV oxytocin infusion early before uterine incision reduces intraoperative blood loss. This could be effective to replace starting IV oxytocin infusion late after umbilical cord clamping or delivery of the placenta.

scholarly journals Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Alaa Elguindy ◽  
Hosam Hemeda ◽  
Mohamed Esmat Shawky ◽  
Maii Nawara ◽  
Mohamed Elsenity ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Controlled Study ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Abdominal Myomectomy ◽  
Randomized Controlled ◽  
Uterine Incision

Abstract Background It has long been believed that longitudinal uterine incision causes less blood loss than transverse incision in myomectomy, yet knowledge of detailed anatomy of vascular supply of a myoma suggests that transverse incision would be a safe choice. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods A randomized controlled study in a university affiliated hospital, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups. Intraoperative blood loss, operative time and postoperative fever were analyzed. Results No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6). Conclusion Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration NCT03009812 at clinicaltrials.gov, registered January 2017

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

Double-blind, randomized controlled trial of tranexamic acid in minor lumbar spine surgery: no effect on operative time, intraoperative blood loss, or complications

2019 ◽  
Vol 31 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Signe Elmose ◽  
Mikkel Ø. Andersen ◽  
Else Bay Andresen ◽  
Leah Yacat Carreon
Keyword(s):  
Placebo Group ◽  
Lumbar Spine ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Operative Time ◽  
Decompressive Surgery ◽  
Lumbar Spine Surgery ◽  
Intraoperative Blood Loss ◽  
Double Blind

OBJECTIVEThe purpose of this study was to investigate the effect of tranexamic acid (TXA) compared to placebo in low-risk adult patients undergoing elective minor lumbar spine surgery—specifically with respect to operative time, estimated blood loss, and complications. Studies have shown that TXA reduces blood loss during major spine surgery. There have been no previous studies on the effect of TXA in minor lumbar spine surgery in which these variables have been evaluated.METHODSThe authors enrolled patients with ASA grades 1 to 2 scheduled to undergo lumbar decompressive surgery at Middelfart Hospital into a double-blind, randomized, placebo-controlled, parallel-group study. Patients with thromboembolic disease, coagulopathy, hypersensitivity to TXA, or a history of convulsion were excluded. Patients were randomly assigned, in blocks of 10, to one of 2 groups, TXA or placebo. Anticoagulation therapy was discontinued 2–7 days preoperatively. Prior to the incision, patients received either a bolus of TXA (10 mg/kg) or an equivalent volume of saline solution (placebo). Independent t-tests were used to compare differences between the 2 groups, with statistical significance set at p < 0.05.RESULTSOf the 250 patients enrolled, 17 patients were excluded, leaving 233 cases for analysis (117 in the TXA group and 116 in the placebo group). The demographics of the 2 groups were similar, except for a higher proportion of women in the TXA group (TXA 50% vs placebo 32%, p = 0.017). There was no significant between-groups difference in operative time (49.53 ± 18.26 vs 54.74 ± 24.49 minutes for TXA and placebo, respectively; p = 0.108) or intraoperative blood loss (55.87 ± 48.48 vs 69.14 ± 83.47 ml for TXA and placebo, respectively; p = 0.702). Postoperative blood loss measured from drain output was 62% significantly lower in the TXA group (13.03 ± 21.82 ml) than in the placebo group (34.61 ± 44.38 ml) (p < 0.001). There was no significant difference in number of dural lesions or postoperative spinal epidural hematomas, and there were no thromboembolic events.CONCLUSIONSTranexamic acid did not have a statistically significant effect on operative time, intraoperative blood loss, or complications. This study gives no evidence to support the routine use of TXA during minor lumbar decompressive surgery.Clinical trial registration no.: NCT03714360 (clinicaltrials.gov)

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