Abdominal myomectomy: A retrospective review of determinants and outcomes of complications at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Adesina, Kikelomo T; Owolabi, Beatrice O; Raji, Hadijat Olaide; Olarinoye, Adebunmi O

doi:10.4314/mmj.v29i1.8

Cited by 25 publications

(25 citation statements)

References 22 publications

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“…Abdominal myomectomy is often preferred to laparoscopic route in the presence of large and multiple uterine leiomyoma (7). Intraoperative hemorrhage necessitating blood transfusion is the commonest complication of abdominal myomectomy (4) and when uncontrollable, it may necessitate hysterectomy (8). The volume of blood loss at abdominal myomectomy depends on the uterine size, number and location of the leiomyoma (7).…”

Section: Introductionmentioning

confidence: 99%

“…The volume of blood loss at abdominal myomectomy depends on the uterine size, number and location of the leiomyoma (7). Generally, blood u n c o r r e c t e d p r o o f 2 transfusion rate for abdominal myomectomy is 13.5 to 58.2% (4,9) with 2% inadvertent hysterectomy rate following uncontrollable hemorrhage (6,9). Therefore, effective interventions to reduce blood loss remain desirable during myomectomy (10).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: a randomized controlled trial

Afolabi¹,

Ezeoke²,

Saidu³

et al. 2018

J Turkish German Gynecol Assoc

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: a randomized controlled trial

Afolabi¹,

Ezeoke²,

Saidu³

et al. 2018

J Turkish German Gynecol Assoc

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“…1 They occur in 20-25% of women of reproductive age causing 3-5% of gynaecology consultations. 2,3 In Nigeria, it is the most common tumour in the female population, prsobably occurring in over 80% of women over the age of 25 years even if only of the size of a seedling. 4 Options available for the treatment of uterine fibroids include; expectant management, medical therapy with gonadotropin-releasing hormone agonists or progesterone receptor modulators, surgical management which may be hysterectomy and myomectomy and can be carried out via hysteroscopy, laparoscopy, or as open abdominal procedure, endometrial ablation, uterine artery occlusion and focused ultrasound.…”

Section: Introductionmentioning

confidence: 99%

“…4 Surgical management is amenable to both General and Central NeuraxialRegional Anaesthesia (spinal, epidural and combined spinal/epidural anaesthesia) and the choice of anaesththesia depends on the expertise of the anaesthetist, patient's preference, surgeons request, duration of the procedure and availability of equipments, lifesaving drugs and anesthetic agents. 3,5,6 However, a technique that is simple and subject to less constraint on personnel, equipment and drugs would be necessary. This is more so in our environment where there is a dearth of anaesthetist, patients are poor, hospital bills are high and resources available for health care are limited.…”

Section: Introductionmentioning

confidence: 99%

Anaesthesia for Fibroid Surgeries: Experience from A Nigerian Tertiary Institution

Fd¹,

Hi²

2020

IJCMR

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Introduction: Worldwide, uterine fibroid is the commonest gynaecological tumour in women. The standard treatment for symptomatic uterine fibroid is surgery. This is facilitated using anaesthesia, which could be general or Central neuraxial block (Regional anaesthesia, RA). In Nigeria, most women present late with huge fibroids which is a main determinant of the mode of anaesthesia. While general anaesthesia (GA) is more commonly used, it is not without challenges necessitating the increasing use of Regional anaesthesia (RA) which is thought to be more beneficial for the patient. This study seeks to audit the anaesthetic practice for fibroid surgeries over a five year period in our Institution, assess the role of RA and to generate awareness with a view to increasing its utilization for fibroid surgeries. Material and methods: The Nurses' and Doctors 'theatre records were reviewed for Socio demographics, type of anaesthesia, type of surgery and uterine size. Result: Summary of statistics was done using percentages, means and standard deviation. Categorical variables were compared using the Chi-square test. A P-value of <0.05 was considered statistically significant. Five hundred and twenty five (525) surgeries were performed for women with uterine fibroid with an age range of 20-65years.Two hundred and fifteen (215/41%) patients had GA, while 284 (54.1%) had RA. Twenty six patients (26.4.9%) had spinal anaesthesia that failed and had to be converted to GA. Conclusion: There was a yearly increase in the use of RA, and a yearly decline in the use of GA. Regional Anaesthesia is the more commonly used mode of anaesthesia for fibroid surgeries in our institution

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“…The standard method for treating uterine fibroids is hysterectomy for women who have completed their childbearing and myomectomy for those who want to preserve their fertility [3] . However, bleeding is one of the most prevalent complications in cases subjected to myomectomy [4] . Literature shows that about 20% of the cases who underwent myomectomy need blood transfusion [2] .…”

Section: Introductionmentioning

confidence: 99%

The effect of misoprostol on intra-operative blood loss during myomectomy operation: Randomized controlled trial

Mohamed

Mansour

Shaker

2019

Evidence Based Women's Health Journal

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Introduction: Uterine myomas are most prevalent benign tumors in reproductive-aged women. Myomectomy is a surgical treatment for symptomatic uterine myomas for women who want to preserve fertility. Uncontrolled intraoperative bleeding with others life-threatening complications make the surgery risky even more than the hysterectomy and require a skilled surgeon, several methods have been developed to reduce this complications. Misoprostol PE1 analogue, which is recently used as treatment and prophylaxis of postpartum hemorrhage, may reduce intra-operative blood loss during abdominal myomectomies when bleeding constitutes a major problem. Aim of the work: Was to assess the effect part of a single dose of Misoprostol (400 microgram) given rectally one hour preoperative on the amount of blood loss during open Myomectomy. Patients and Methods: In a prospective randomized double-blind placebo-controlled trial which was conducted at Ain shams maternity Hospital in Cairo from October 2017 to May 2018, 50 women undergoing abdominal myomectomy for symptomatic uterine myomas were randomly divided into 2 groups : Group I (control group) consisted of 25 patients, each patient was given 2 tablets of placebo trans-rectally one hour preoperatively and without any intervention to reduce blood loss and Group II (study group) consisted of 25 patients, each patient was given 400 micrograms of misoprostol transrectally one hour preoperatively. The primary outcome was intraoperative blood loss. This clinical trial was registered in clinicaltrial.gov registry with number: NCT03483142. Results: Intra-operative blood loss was significantly lower in those women randomized to receive rectal misoprostol versus the placebo group (460.8-155.2 mL vs. 815.4 -187.7 mL). Misoprostol group showed lower mean blood loss (P<0.01) ; additionally, there was a highly significant statistical difference between Misoprostol group and placebo group as regards the postoperative hemoglobin, hematocrit concentration, operative time and IV fluid infusion during surgery (P<0.01) as Misoprostol group showed a higher postoperative hemoglobin and hematocrit concentration, and less operative time and infused IV fluid. There was no statistical significant difference between both groups as regards the blood transfusion. Conclusion: Preoperative single dose of rectal misoprostol (400 micrograms) is an effective simple method for reducing intra-operative bleeding, operative time, mean post-operative HB and Hct drop.

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Abdominal myomectomy: A retrospective review of determinants and outcomes of complications at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Abstract: Background

Cited by 25 publications

References 22 publications

Comparing perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: a randomized controlled trial

Comparing perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: a randomized controlled trial

Anaesthesia for Fibroid Surgeries: Experience from A Nigerian Tertiary Institution

The effect of misoprostol on intra-operative blood loss during myomectomy operation: Randomized controlled trial

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