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https://www.readbyqxmd.com/read/25767949/the-management-of-uterine-leiomyomas
#1
George A Vilos, Catherine Allaire, Philippe-Yves Laberge, Nicholas Leyland, Angelos G Vilos, Ally Murji, Innie Chen
OBJECTIVES: The aim of this guideline is to provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. OPTIONS: The areas of clinical practice considered in formulating this guideline were assessment, medical treatments, conservative treatments of myolysis, selective uterine artery occlusion, and surgical alternatives including myomectomy and hysterectomy...
February 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/25125317/interventions-to-reduce-haemorrhage-during-myomectomy-for-fibroids
#2
REVIEW
Eugene J Kongnyuy, Charles Shey Wiysonge
BACKGROUND: Benign smooth muscle tumours of the uterus, known as fibroids or myomas, are often symptomless. However, about one-third of women with fibroids will present with symptoms that are severe enough to warrant treatment. The standard treatment of symptomatic fibroids is hysterectomy (that is surgical removal of the uterus) for women who have completed childbearing, and myomectomy for women who desire future childbearing or simply want to preserve their uterus. Myomectomy, the surgical removal of myomas, can be associated with life-threatening bleeding...
2014: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/22071823/interventions-to-reduce-haemorrhage-during-myomectomy-for-fibroids
#3
REVIEW
Eugene J Kongnyuy, Charles Shey Wiysonge
BACKGROUND: Uterine myomas (fibroids) are benign tumours of the uterus. Myomectomy, the surgical removal of myomas, can be associated with life-threatening bleeding and prolonged postoperative stay. Knowledge of the effectiveness of the interventions to reduce bleeding during myomectomy is essential to enable evidence-based clinical decisions. This is an update of the review published in The Cochrane Library Issue 3, 2009. OBJECTIVES: To assess the effectiveness, safety, tolerability, and costs of interventions to reduce blood loss during myomectomy...
2011: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/21970233/trends-of-myomectomy-at-the-university-of-nigeria-teaching-hospital-unth-enugu-nigeria
#4
T C Okeke, O A Okezie, K C E Obioha, L C Ikeako, C C Ezenyeaku
BACKGROUND: Uterine fibroid is the commonest female genital tumour occurring within the reproductive age group, and abdominal myomectomy is the most offered surgical treatment in our environment. There is need to audit this practice in our centre so as to observe the practice pattern and outcome of myomectomies in Enugu, Nigeria. OBJECTIVE: To audit myomectomies, the practice pattern and outcome at the University of Nigeria Teaching Hospital Enugu-Nigeria. METHODS: A 5-year retrospective study of myomectomies performed in UNTH Enugu between January 1, 2004 and December 31, 2008...
April 2011: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
https://www.readbyqxmd.com/read/21280999/ovarian-artery-clamp-initial-experience-with-a-new-clamp-to-reduce-bleeding-at-open-myomectomy
#5
A Magos, N Al-Shabibi, I Korkontzelos, N Gkioulekas, I Tsibanakos, A Gkoutzioulis, M Moustafa
We studied the effect of novel ovarian artery clamps on intraoperative bleeding in 46 women undergoing open myomectomy for large fibroids. The clamps were applied medial to the ovaries to occlude uterine blood flow from the ovarian arteries without compressing the fallopian tubes, and were used in conjunction with a pericervical tourniquet. Myomectomy was completed successfully in all patients, and an average of 10 fibroids weighing 588 g were removed per patient. The clamps could be applied bilaterally in all but three cases...
2011: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/20499747/the-use-of-torniquet-to-reduce-blood-loss-at-myomectomy
#6
RANDOMIZED CONTROLLED TRIAL
J I Ikechebelu, C O Ezeama, N J A Obiechina
BACKGROUND: Fibroids remain the commonest pelvic tumour seen in women with myomectomy being the major form of treatment in our environment. Techniques to minimize blood loss will reduce patient morbidity and the need for blood transfusions. One such technique is the use of a tourniquet during myomectomy operation. This study examines the effectiveness and safety this tourniquet technique. METHOD: A comparative analysis of the blood loss, transfusion rate and the morbidities associated with the use and non-use of a tourniquet during myomectomy operation at Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria was undertaken...
June 2010: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/20056203/two-cases-of-myomectomy-complicated-by-intravascular-hemolysis-and-renal-failure-disseminated-intravascular-coagulation-or-hemolytic-uremic-syndrome
#7
Ioannis Tsimpanakos, John Connolly, Kyriaki S Alatzoglou, Camilla Rowan, Adam Magos
OBJECTIVE: To present two cases of myomectomy complicated by intravascular hemolysis leading to acute renal failure and discuss the differential diagnosis and possible mechanism. DESIGN: Case report. SETTING: Minimally Invasive Therapy Unit, University Department of Obstetrics and Gynecology. PATIENT(S): Two premenopausal patients with uterine fibroids. INTERVENTION(S): Both patients underwent otherwise uncomplicated myomectomies, one by laparotomy and one by laparoscopy, with tourniquets around the uterine and ovarian vessels being used to control intraoperative bleeding...
April 2010: Fertility and Sterility
https://www.readbyqxmd.com/read/19588371/interventions-to-reduce-haemorrhage-during-myomectomy-for-fibroids
#8
REVIEW
Eugene J Kongnyuy, Charles Shey Wiysonge
BACKGROUND: Uterine myomas (fibroids) are benign tumours of the uterus. Myomectomy, the surgical removal of myomas, is an important treatment option especially for women who wish to preserve their uteri. The major problem with myomectomy is excessive bleeding, which can be life-threatening and prolong postoperative stay. Knowledge of the effectiveness of the interventions to reduce bleeding during myomectomy is essential to enable evidence-based clinical decisions. OBJECTIVES: To assess the effectiveness, safety, tolerability, and costs of interventions to reduce blood loss during myomectomy...
2009: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/19191779/prospective-randomised-trial-comparing-gonadotrophin-releasing-hormone-analogues-with-triple-tourniquets-at-open-myomectomy
#9
RANDOMIZED CONTROLLED TRIAL
N Al-Shabibi, L Chapman, S Madari, A Papadimitriou, P Papalampros, A Magos
OBJECTIVE: To compare intra-operative blood loss with triple tourniquets to occlude uterine blood supply against preoperative treatment with gonadotrophin-releasing hormone (GnRH) analogues at open myomectomy. DESIGN: A prospective randomised controlled trial. SETTING: University teaching hospital. POPULATION: Forty women undergoing open myomectomy for symptomatic fibroids. METHODS: Women due to undergo open myomectomy were randomised to either 3 months pre-treatment with a GnRH analogue or the intra-operative application of triple tourniquets (number 1 polyglactin suture [Vicryl Ethicon Inc...
April 2009: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/17894936/a-systematic-review-of-randomized-controlled-trials-to-reduce-hemorrhage-during-myomectomy-for-uterine-fibroids
#10
REVIEW
E J Kongnyuy, N van den Broek, C S Wiysonge
OBJECTIVE: To assess the effectiveness and safety of interventions to reduce blood loss during myomectomy. METHODS: Electronic searches of the Cochrane Library, MEDLINE, and EMBASE, between 1966 and 2006 for randomized controlled trials (RCTs). RESULTS: We found significant reductions in blood loss with vaginal misoprostol (weighted mean difference [WMD] -149.00 mL, 95% confidence interval [CI] -229.24 to -68.76); intramyometrial vasopressin and analogues (WMD -298...
January 2008: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/17253552/interventions-to-reduce-haemorrhage-during-myomectomy-for-fibroids
#11
REVIEW
E J Kongnyuy, C S Wiysonge
BACKGROUND: Uterine myomas (fibroids) are benign tumours of the uterus. Myomectomy, the surgical removal of the myomas, is an important treatment option especially for women who desire to preserve their uteri. The major problem with myomectomy is excessive bleeding from increased uterine blood supply, and this can be life-threatening and prolong postoperative stay. Knowledge of the effectiveness of the interventions used to reduce blood loss during myomectomy is essential to enable evidence-based clinical decisions...
2007: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/16240429/color-doppler-evaluation-of-changes-in-uterine-perfusion-induced-by-the-use-of-an-absorbable-cervical-tourniquet-during-open-myomectomy
#12
RANDOMIZED CONTROLLED TRIAL
Alexander Taylor, Sally Blackmore, Panos Tsirkas, Adam Magos
PURPOSE: To evaluate the hemodynamic changes in uterine perfusion following the vascular occlusion of the uterine arteries with an absorbable cervical tourniquet applied during open myomectomy. METHODS: Twenty-eight patients with symptomatic fibroids and a clinical uterine size equivalent to 14 or more weeks' gestation underwent open myomectomy. Patients were randomized to either the tourniquet or the control group. In the tourniquet group, a number 1 polyglactin suture was tied around the cervix to occlude the uterine arteries and left in situ...
October 2005: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/16147630/myomectomy-can-be-life-saving-a-case-of-a-36-week-fibroid-uterus-managed-conservatively-in-a-40-year-old-nulliparous-woman
#13
S Lim, A Taylor, A Di Spiezio Sardo, G Mastrogamvrakis, M Sharma, L Buck, A Magos
No abstract text is available yet for this article.
September 2004: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/15842213/surgical-and-radiological-management-of-uterine-fibroids-a-uk-survey-of-current-consultant-practice
#14
Alexander Taylor, Malini Sharma, Panos Tsirkas, Rohit Arora, Attilio Di Spiezio Sardo, George Mastrogamvrakis, Lucie Buck, Mac Oak, Adam Magos
BACKGROUND: The aim of this study was to determine the current surgical and radiological management of uterine fibroids by consultants working in the UK. METHODS: A structured questionnaire was posted to all 1439 UK consultants. Non-responders were sent one reminder. The main outcome measures were surgical route and technique used for myomectomy, and the use and availability of uterine artery embolization (UAE). RESULTS: Eight hundred fifty-two (59%) consultants replied...
May 2005: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/15713151/reducing-blood-loss-at-open-myomectomy-using-triple-tourniquets-a-randomised-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
A Taylor, M Sharma, P Tsirkas, A Di Spiezio Sardo, M Setchell, A Magos
OBJECTIVES: To evaluate triple tourniquets in controlled conditions and for the first time to investigate the hypothesis that leaving a semi-permanent tourniquet around the uterine artery reduces post-operative bleeding from the uterine incisions. DESIGN: A randomised controlled trial. SETTING: Two University teaching hospitals. POPULATION: Twenty-eight patients with symptomatic fibroids and uterine sizes ranging from 14 to 24 weeks of gestation undergoing open myomectomy...
March 2005: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/12685407/caesarean-myomectomy
#16
COMPARATIVE STUDY
E Yao Kwawukume
This study was conducted at Korle Bu Teaching Hospital and Family Health Hospital, Accra, Ghana, between April 2000 and January 2001 to compare the efficacy and safety of myomectomy done at caesarean section with the application of a tourniquet with caesarean section without myomectomy. Twenty four patients were recruited into the study. Average haemoglobin of patients both pre and post-operatively was 11.73 g/dl and 9.90 g/dl for patients who had caesarean section with myomectomy and 12.07 g/dl and 10.34 g/dl in the other group in which caesarean section without myomectomy was performed...
December 2002: African Journal of Reproductive Health
https://www.readbyqxmd.com/read/8243699/the-effect-of-operative-technique-and-uterine-size-on-blood-loss-during-myomectomy-a-prospective-randomized-study
#17
RANDOMIZED CONTROLLED TRIAL
E S Ginsburg, C B Benson, J M Garfield, R E Gleason, A J Friedman
OBJECTIVES: To compare operative blood loss between two accepted blood loss-reducing techniques used during myomectomy and to evaluate the effect of preoperatively determined uterine volume on blood loss. DESIGN: Subjects were stratified by ultrasound-determined uterine volume < 600 cm3 (n = 11) and > or = 600 cm3 (n = 10) and then randomized into treatment groups. The same radiologist, surgeons, and anesthetic induction technique were involved in every case...
December 1993: Fertility and Sterility
https://www.readbyqxmd.com/read/3518894/myomectomy
#18
REVIEW
M E Boyd
If fibroids require treatment, hysterectomy is usually the therapy of choice. Myomectomy is best reserved for women who wish to preserve their uterus and have a single large fibroid tumour; it is not normally recommended for either abnormal uterine bleeding or infertility. The blood supply of leiomyomas is from the periphery and is such that degeneration frequently ensues. Degeneration, in particular the acute degeneration that may occur in pregnancy, is rarely an indication for operation. Myomectomy has been associated with considerable blood loss intraoperatively and prolonged morbidity postoperatively...
May 1986: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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