Temporary endovascular balloon occlusion of the bilateral internal iliac arteries for control of hemorrhage during laparoscopic-assisted myomectomy in a nulligravida with a large cervical myoma

Takeda, Akihiro; Koyama, Kazuyuki; Imoto, Sanae; Mori, Masahiko; Sakai, Kotaro; Nakamura, Hiromi

doi:10.1016/j.fertnstert.2008.09.040

Cited by 26 publications

(29 citation statements)

References 11 publications

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“…1D and 3H). In large CM with myoma weight more than 500 g, complete enucleation is difficult because of limited pelvic space for traction; the myoma was morcellated by an electric morcellator while still attached to the uterus (5,6,9,10). In the present study, the case with myoma weight of 1,200 g was in a 33-year-old woman.…”

Section: Discussionmentioning

confidence: 62%

“…Among them, 28 patients had both image and surgically proven CM. In this study we classified these cases of CM into the following five types according to location: [1] anterior cervical myoma (ACM); [2] posterior cervical myoma (PCM); [3] central cervical myoma (CCM); [4] lateral cervical myoma (LCM); and [5] deeprooted cervical myoma [DCM].…”

Section: Methodsmentioning

confidence: 99%

“…After the CM was completely enucleated, morcellation was performed. If complete enucleation is difficult with large myomas and limited pelvic space for traction, the myoma was morcellated with an electric morcellator while still attached to the uterus (5,6,9,10). The wound was closed with 1-0 Vicryl (Polyglactin 910; Johnson & Johnson, Somerville, NJ) suture.…”

Section: General Surgical Techniques For Laparoscopic Myomectomymentioning

confidence: 99%

“…These structures include the bladder in front of the cervix, the rectum behind the cervix, and the uterine arteries and ureters on both sides. Myomectomy for CMs is empirically difficult and frequently problematic (4,5). The approach should be varied according to the size and location of the myoma.…”

mentioning

confidence: 99%

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Strategy of cervical myomectomy under laparoscopy

Chang

Chen

Huang

et al. 2010

Fertility and Sterility

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Section: Discussionmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Section: General Surgical Techniques For Laparoscopic Myomectomymentioning

confidence: 99%

mentioning

confidence: 99%

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Strategy of cervical myomectomy under laparoscopy

Chang

Chen

Huang

et al. 2010

Fertility and Sterility

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“…We therefore decided to perform temporary endovascular balloon occlusion of the affected unilateral internal iliac artery for the immediate management of hemorrhage from retroperitoneal arteries during dissection of fibro-fatty-connective tissue. The usefulness of temporary endovascular balloon occlusion of bilateral internal iliac arteries has been reported in the management of obstetric hemorrhage due to abnormal placentation (Carnevale et al 2011), myomectomy (Takeda et al 2009) and hysterectomy procedures in cases of large cervical myoma (Takeda et al 2011). In our case, bleeding increased after balloon deflation, indicating that unilateral occlusion of the internal iliac artery was considerably effective in controlling bleeding.…”

Section: Discussionmentioning

confidence: 99%

Uterine Arteriovenous Malformation Formed in a Large Uterine Cervical Myoma

Soeda

Ushijima

Furukawa

et al. 2012

Tohoku J. Exp. Med.

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Arteriovenous malformation (AVM) can arise in various organs, particularly the brain, but it is rare in the uterus. Uterine AVM is potentially lethal and is generally associated with uterine trauma, such as dilatation and curettage, therapeutic abortion or uterine surgery. On the other hand, uterine myoma is the most common benign gynecological tumor, but uterine cervical myoma is rare and grows in the extraperitoneal space, with development of complex capillary networks within the tumor. Cervical myoma surgery is therefore a difficult operation with a risk of massive bleeding. We report herein a patient with uterine AVM formed within a large cervical myoma in a postmenopausal woman. The patient was a 55-year-old Japanese woman who complained of lower abdominal distension. Ultrasonography, computed tomography and magnetic resonance imaging showed an 18 × 20-cm uterine cervical tumor with dilatation of numerous vessels. Pelvic angiography was scheduled to provide accurate diagnosis and to minimize intraoperative blood loss. In fact, preoperative pelvic angiography allowed us to identify the true feeding artery and drainage veins. Occlusion of the feeding artery with a balloon device is effective in decreasing intraoperative bleeding. Abdominal total hysterectomy was performed as the surgical management of this uterine AVM. Prophylactic endovascular balloon occlusion of the ipsilateral internal iliac artery reduced the amount of hemorrhage during surgery, although blood transfusion was needed in our patient. In conclusion, preoperative embolosclerotherapy should be considered as a treatment option in patients with AVM present in a large uterine cervical myoma.

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Temporal intrailiac balloon occlusion for the treatment of intractable pelvic fracture hemorrhage

Ishida

Noborio

Shimahara

et al. 2015

Acute Medicine & Surgery

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Case: A 48-year-old schizophrenic man sustained multiple injuries following a fall. Unstable pelvic fractures were diagnosed in the emergency department. The patient's hemodynamic status was stabilized following bilateral internal iliac artery embolization using a gelatin sponge. However, recurrent bleeding and an expanding retroperitoneal hemorrhage occurred 1 h after transcatheter arterial embolization.Outcome: Using temporal intrailiac balloon occlusion, with preperitoneal gauze packing, the patient's hemodynamic status was stabilized in the intensive care unit. No complications were observed following transcatheter arterial embolization and balloon occlusion. Conclusions:Temporary intrailiac balloon occlusion is a rapid and safe treatment for refractory pelvic hemorrhage, which can be administered simultaneously with other treatments including preperitoneal gauze packing and external fixation.

show abstract

Temporary endovascular balloon occlusion of the bilateral internal iliac arteries for control of hemorrhage during laparoscopic-assisted myomectomy in a nulligravida with a large cervical myoma

Cited by 26 publications

References 11 publications

Strategy of cervical myomectomy under laparoscopy

Strategy of cervical myomectomy under laparoscopy

Uterine Arteriovenous Malformation Formed in a Large Uterine Cervical Myoma

Temporal intrailiac balloon occlusion for the treatment of intractable pelvic fracture hemorrhage

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