Abstract
The study was undertaken to determine the effectiveness of bilateral hypogastric
artery occlusion in minimizing blood loss from abdominal hysterectomy. The subjects
under study were patients with myoma uteri who attended the Kabinburi Hospital for
surgical intervention in the period August 1, 2000 to July 31, 2007. The patients were
divided by simple random sampling into two groups; the initial numbers were 33 in the study group undergoing bilateral hypogastric artery occlusion right before hysterectomy
and 32 in the control group with no artery occlusion. After the abdominal hysterectomy,
Five patients were excluded after hysterectomy but not the cases of myoma, thus making
the patients numbers 30 each in both groups. With the same provision of preoperative,
operative and postoperative care for all patients, the procedure of bilateral hypogastric
artery occlusion was performed on the study group by the present author just before the
uterus removal operation and occlusion release after the hysterectomy was completed
and all the bleeders were checked.
The results of this study showed no statistically significant differences between the
two groups regarding their personal data and the operative outcomes. The average blood
loss in the study group was 350.67 ± 140.38 ml, whereas in the control group it was 572.83
± 207.82 ml; the difference was statistically significant (p < 0.05). The study group received
0.13 ± 0.346 units of blood transfusion during the operation, whereas the control
group received 0.63 ± 0.765 units; the difference was statistically significant (p < 0.05).
The operative time taken in the study group was 85.23 ± 17.17 minutes compared with
104.53 ± 16.06 minutes in the control group; the difference was statistically significant (p
< 0.05). There were no significant differences between the two groups regarding preoperative
and the 24-hour postoperative hematocrit levels, the numbers of pads used in the
first post- operative days, incidence of postoperative fever or infection, other organ injuries,
and the average length of hospital stay post operation. The study was conducted to
support the practice of temporary bilateral hypogastric artery occlusion in order to minimize
blood loss during abdominal hysterectomy.
