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Influence factors of the intraoperative bleeding during laparoscopic hysteromyomectomy fibroids |
1.Huangshan City People's Hospital, Huangshan, Anhui Province, 245000;2.Huangshan Shoukang Hospital, Huangshan, Anhui Province |
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Abstract To explore the influencing factors of the excessive intraoperative bleeding during laparoscopic hysteromyomectomy of patients with uterine fibroids. Methods: The clinical data of 80 patients with uterine fibroids who had received laparoscopic hysteromyomectomy from December 2020 to December 2023 were selected in this study. The difference of the intraoperative blooding amount of the patients with different size, location and number of the uterine fibroids was analyzed. The correlation between the operative time of the patients and their intraoperative blooding amount was analyzed. Logistic regression analysis was used to analyze the risk factors affecting the amount of intraoperative blood loss of the patients during laparoscopic hysteromyomectomy. Results: The amount of intraoperative blooding (84.16±19.33 ml) of the patients with uterine fibroids ≥5cm was significantly higher than that (50.79±23.97 ml) of the patients with uterine fibroids <5cm. The amount of the intraoperative blooding (82.63±23.61 ml) of the patients with uterine fibroids located in the wall of the uterine muscle was significantly higher than that (50.95±18.16 ml) of the patients with subserosal uterine fibroids. The amount of the intraoperative blooding (81.46±20.46 ml) of the patients with multiple uterine fibroids was significantly higher than that (55.02±22.46 ml) of the patients with single uterine fibroids. The amount of the intraoperative blooding (80.99±18.91 ml) of the patients with the operation time >62.85 min was significantly higher than that (59.72±23.47 ml) of the patients with operation time ≤62.85 min (all P<0.05). Pearson correlation analysis showed that there was a positive correlation between the operation time of the patients and their intraoperative blood loss (P<0.05). Logistic regression analysis showed that the uterine fibroids ≥5cm, the uterine fibroids located in the wall of the uterine muscle, the multiple number of uterine fibroids and the operation time of myomectomy > 62.85 min of the patients were the risk factors of their increased blood loss during laparoscopic myomectomy (P<0.05). There were 5 patients with the blood transfusion during the operation, including 3 cases with the anemia before operation and 2 cases with large uterine fibroids. There was no any patient with related complications occurred after operation. Conclusion: For the patients undergoing hysteromyectomy, the larger uterine fibroids, the uterine fibroids located in the wall of the uterine muscle, the multiple uterine fibroids and the longer operation time of the patients are the risk factors of their increased intraoperative blood loss, which need to be prevented and treated in clinic, and the blood transfusion is needed if necessary, so as to avoid the postoperative complications.
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