Abdominal myomectomy can be a challenging procedure, with elevated intraoperative blood loss and post-operative complications such as the need for blood transfusion and hemostasis with sometimes hysterectomy. Previous studies suggested that preemptive uterine artery embolization (PUAE) might reduce intraoperative blood loss. We reviewed all cases of abdominal myomectomy in our institution between January 2016 and June 2018. Out of 119 cases, 16 patients had PUAE and 103 did not. The objective of our study was to determine whereas PUAE reduced blood loss and post-operative complication rate. In our study, there was no difference between the two groups in regard to average blood loss (128 vs 192 mL, OR 1,00 [0.99;1,01], p = 0,73), difference between pre- and post-operative hemoglobin level (− 1,15 g/dL vs − 1,32 g/dL, OR 0,91 [0.47;1,73], p = 0,79), and post-operative complications (need for transfusion, surgical revision, post-operative embolization, hysterectomy). Our findings could not conclude that PUAE is effective in reducing intraoperative blood loss during abdominal myomectomy, but it should still be considered an option for patients with large or multiple myomas, with a specific situation or previously operated, who wish to preserve their uterus.

中文翻译：

---

降低子宫肌瘤切除术后出血的风险：先发性栓塞是一种有价值的工具吗？


腹部子宫肌瘤切除术可能是一项具有挑战性的手术，术中失血量增加，术后出现并发症，例如需要输血和止血，有时需要子宫切除术。先前的研究表明，先发性子宫动脉栓塞（PUAE）可能会减少术中失血。我们回顾了 2016 年 1 月至 2018 年 6 月期间在我们机构进行的所有腹部子宫肌瘤切除术病例。在 119 例病例中，16 名患者患有 PUAE，103 名患者没有。我们研究的目的是确定 PUAE 可以减少失血量和术后并发症发生率。在我们的研究中，两组之间的平均失血量（128 vs 192 mL，OR 1,00 [0.99;1,01]，p = 0.73）、术前和术后差异没有差异。手术血红蛋白水平（− 1,15 g/dL vs − 1,32 g/dL，OR 0,91 [0.47;1,73]，p = 0,79）和术后并发症（需要输血、手术翻修、术后栓塞、子宫切除术）。我们的研究结果不能得出结论认为 PUAE 可以有效减少腹部子宫肌瘤切除术中的术中失血，但对于患有大型或多发性肌瘤、有特殊情况或既往接受过手术、希望保留子宫的患者，仍应考虑将其视为一种选择。