Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 4/2012

01-04-2012 | General Gynecology

Retrospective analysis of the efficacy of perioperative use of the cell salvage and autologous blood recovery system during laparoscopic myomectomy

Authors: Jun Kumakiri, Iwaho Kikuchi, Mari Kitade, Shozo Matsuoka, Ayako Kono, Satoru Takeda

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Login to get access

Abstract

Purpose

To evaluate the benefit of the intraoperative use of a cell salvage and autologous blood recovery system during laparoscopic myomectomy (LM).

Methods

We retrospectively reviewed the medical records of 538 patients who underwent LM between January 2008 and December 2009 at our hospital. Patients undergoing LM were divided into two groups depending on whether the cell salvage and autologous blood recovery system was used; the use of the system was at the discretion of the surgeon. The system for intraoperative hemorrhage was employed based on the surgeon’s decision.

Results

Of the 583 patients, 23 patients (4.3%) underwent LM using the system. No patient required an allogeneic blood transfusion during or after the surgery. The median surgical time (183 vs. 100 m), total blood loss (520 vs. 100 mL), total weight of enucleated myomas (390 vs. 175 g), and postoperative calculated δ-Hemoglobin (δ-Hb) (2 vs. 1.6 g/dL) were significantly increased in the 23 patients in whom the system was used. The median autologous blood volume recovered by intraoperative use of the system and transferred to the 23 patients was 250 mL (range 125–800 mL). For patients in whom the system was not used, the total blood loss significantly correlated to δ-Hb (r = 0.29; P < 0.01). However, there was no such correlation in patients in whom the system was not used (r = 0.04; P = 0.86).

Conclusions

The adoption of a cell salvage and autologous blood recovery system during LM was useful for patients with severe hemorrhage.
Literature
1.
go back to reference Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kumakiri J, Takeda S (2008) Influencing factors of adhesion development and the efficacy of adhesion-preventing agents in patients undergoing laparoscopic myomectomy as evaluated by a second-look laparoscopy. Fertil Steril 89:1247–1253PubMedCrossRef Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kumakiri J, Takeda S (2008) Influencing factors of adhesion development and the efficacy of adhesion-preventing agents in patients undergoing laparoscopic myomectomy as evaluated by a second-look laparoscopy. Fertil Steril 89:1247–1253PubMedCrossRef
2.
go back to reference Tinelli A, Malvasi A, Guido M et al (2011) Adhesion formation after intracapsular myomectomy with or without adhesion barrier. Fertil Steril 95:1780–17855PubMedCrossRef Tinelli A, Malvasi A, Guido M et al (2011) Adhesion formation after intracapsular myomectomy with or without adhesion barrier. Fertil Steril 95:1780–17855PubMedCrossRef
3.
go back to reference Hurst BS, Matthews ML, Marshburn PB (2005) Laparoscopic myomectomy for symptomatic uterine myomas. Fertil Steril 83:1–23PubMedCrossRef Hurst BS, Matthews ML, Marshburn PB (2005) Laparoscopic myomectomy for symptomatic uterine myomas. Fertil Steril 83:1–23PubMedCrossRef
4.
go back to reference Kumakiri J, Takeuchi H, Kitade M et al (2005) Pregnancy and delivery after laparoscopic myomectomy. J Minim Invasive Gynecol 12:241–246PubMedCrossRef Kumakiri J, Takeuchi H, Kitade M et al (2005) Pregnancy and delivery after laparoscopic myomectomy. J Minim Invasive Gynecol 12:241–246PubMedCrossRef
5.
go back to reference Paul PG, Koshy AK, Thomas T (2006) Pregnancy outcomes following laparoscopic myomectomy and single-layer myometrial closure. Hum Reprod 21:3278–3281PubMedCrossRef Paul PG, Koshy AK, Thomas T (2006) Pregnancy outcomes following laparoscopic myomectomy and single-layer myometrial closure. Hum Reprod 21:3278–3281PubMedCrossRef
6.
go back to reference Seracchioli R, Manuzzi L, Vianello F et al (2006) Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril 86:159–165PubMedCrossRef Seracchioli R, Manuzzi L, Vianello F et al (2006) Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril 86:159–165PubMedCrossRef
7.
go back to reference Zullo F, Pellicano M, De Stefano R, Zupi E, Mastrantonio P (1998) A prospective randomized study to evaluate leuprolide acetate treatment before laparoscopic myomectomy: efficacy and ultrasonographic predictors. Am J Obstet Gynecol 178:108–112PubMedCrossRef Zullo F, Pellicano M, De Stefano R, Zupi E, Mastrantonio P (1998) A prospective randomized study to evaluate leuprolide acetate treatment before laparoscopic myomectomy: efficacy and ultrasonographic predictors. Am J Obstet Gynecol 178:108–112PubMedCrossRef
8.
go back to reference Jasonni VM, D’Anna R, Mancuso A, Caruso C, Corrado F, Leonardi I (2001) Randomized double-blind study evaluating the efficacy on uterine fibroids shrinkage and on intra-operative blood loss of different length of leuprolide acetate depot treatment before myomectomy. Acta Obstet Gynecol Scand 80:956–958PubMedCrossRef Jasonni VM, D’Anna R, Mancuso A, Caruso C, Corrado F, Leonardi I (2001) Randomized double-blind study evaluating the efficacy on uterine fibroids shrinkage and on intra-operative blood loss of different length of leuprolide acetate depot treatment before myomectomy. Acta Obstet Gynecol Scand 80:956–958PubMedCrossRef
9.
go back to reference Ginsburg ES, Benson CB, Garfield JM, Gleason RE, Friedman AJ (1993) The effect of operative technique and uterine size on blood loss during myomectomy: a prospective randomized study. Fertil Steril 60:956–962PubMed Ginsburg ES, Benson CB, Garfield JM, Gleason RE, Friedman AJ (1993) The effect of operative technique and uterine size on blood loss during myomectomy: a prospective randomized study. Fertil Steril 60:956–962PubMed
10.
go back to reference Shimanuki H, Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kinoshita K (2006) The effect of vasopressin on local and general circulation during laparoscopic surgery. J Minim Invasive Gynecol 13:190–194PubMedCrossRef Shimanuki H, Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kinoshita K (2006) The effect of vasopressin on local and general circulation during laparoscopic surgery. J Minim Invasive Gynecol 13:190–194PubMedCrossRef
11.
go back to reference Wang G, Bainbridge D, Martin J, Cheng D (2009) The efficacy of an intraoperative cell saver during cardiac surgery: a meta-analysis of randomized trials. Anesth Analg 109:320–330PubMedCrossRef Wang G, Bainbridge D, Martin J, Cheng D (2009) The efficacy of an intraoperative cell saver during cardiac surgery: a meta-analysis of randomized trials. Anesth Analg 109:320–330PubMedCrossRef
12.
go back to reference Ashworth A, Klein AA (2010) Cell salvage as part of a blood conservation strategy in anaesthesia. Br J Anaesth 105:401–416PubMedCrossRef Ashworth A, Klein AA (2010) Cell salvage as part of a blood conservation strategy in anaesthesia. Br J Anaesth 105:401–416PubMedCrossRef
13.
go back to reference Yamada T, Yamashita Y, Terai Y, Ueki M (1997) Intraoperative blood salvage in abdominal uterine myomectomy. Int J Gynaecol Obstet 56:141–145PubMedCrossRef Yamada T, Yamashita Y, Terai Y, Ueki M (1997) Intraoperative blood salvage in abdominal uterine myomectomy. Int J Gynaecol Obstet 56:141–145PubMedCrossRef
14.
go back to reference Landi S, Zaccoletti R, Ferrari L, Minelli L (2001) Laparoscopic myomectomy: technique, complications, and ultrasound scan evaluations. J Am Assoc Gynecol Laparosc 8:231–240PubMedCrossRef Landi S, Zaccoletti R, Ferrari L, Minelli L (2001) Laparoscopic myomectomy: technique, complications, and ultrasound scan evaluations. J Am Assoc Gynecol Laparosc 8:231–240PubMedCrossRef
15.
go back to reference West S, Ruiz R, Parker WH (2006) Abdominal myomectomy in women with very large uterine size. Fertil Steril 85:36–39PubMedCrossRef West S, Ruiz R, Parker WH (2006) Abdominal myomectomy in women with very large uterine size. Fertil Steril 85:36–39PubMedCrossRef
16.
go back to reference Sizzi O, Rossetti A, Malzoni M et al (2007) Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 14:453–462PubMedCrossRef Sizzi O, Rossetti A, Malzoni M et al (2007) Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 14:453–462PubMedCrossRef
17.
go back to reference Dubuisson JB, Fauconnier A, Fourchotte V, Babaki-Fard K, Coste J, Chapron C (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16:1726–1731PubMedCrossRef Dubuisson JB, Fauconnier A, Fourchotte V, Babaki-Fard K, Coste J, Chapron C (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16:1726–1731PubMedCrossRef
Metadata
Title
Retrospective analysis of the efficacy of perioperative use of the cell salvage and autologous blood recovery system during laparoscopic myomectomy
Authors
Jun Kumakiri
Iwaho Kikuchi
Mari Kitade
Shozo Matsuoka
Ayako Kono
Satoru Takeda
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-2118-0

Other articles of this Issue 4/2012

Archives of Gynecology and Obstetrics 4/2012 Go to the issue