Triple vs. single uterine tourniquet to reduce hemorrhage at myomectomy: a randomized trial.

PURPOSE: This study aimed to compare the effect of triple uterine tourniquet and single tourniquet on intraoperative blood loss during open myomectomy. METHODS: Women were randomized to undergo open myomectomy with a triple (n = 30) or single uterine tourniquet (n = 30). All symptomatic women aged 18-48 who had three or more myomas or at least one myoma greater than 8 cm if there were less than three myomas were eligible for the study. The primary outcome variable was the volume of intraoperative blood loss. The sample size was set to detect a 240 ml difference in blood loss with 80% power at α = 0.05, with an effect size of 0.8. The rate of transfusions, change in hemoglobin, volume of drains, operation time, tourniquet time, and perioperative complications were secondary outcomes. RESULTS: We found no significant difference in intraoperative blood loss between triple and single uterine tourniquets (527 [102-2931]) ml vs. 508 [172-2764] ml, p = 0.238). Between the single and triple tourniquet groups, the median weight of myoma (379 [136-3850] vs. 330 [140-1636] g, p = 0.451) and median number (1 [1-18] vs. 2 (1-13), p = 0.214), total operation time (84 ± 31 min vs. 79 ± 27 min, p = 0.503), ischemia time (35 ± 21 min vs. 30 ± 14 min., p = 0.238), drain volume at 48th hour (196 ± 89)ml vs. 243 ± 148 ml, p = 0.144) and decrease in hemoglobin (2.3 ± 1.8 g/dl vs. 2.8 ± 1.4 g/dl, p = 0.437) were similar. Eight (27%) patients in the triple tourniquet group and 12 (40%) patients in the single tourniquet group were transfused (p = 0.273). One patient underwent hysterectomy 6-8 h after myomectomy in a single tourniquet group. CONCLUSION: There was no clinically significant difference in intraoperative blood loss between triple and single uterine tourniquets during open myomectomy. CLINICAL TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: ClinicalTrials.gov ID: NCT02392585, 03/13/2015.

May endocan be a new biomarker in the diagnosis of endometriosis?

AIM: As known, inflammatory substances are considered to have a role in the onset and progression of endometriosis. In this study, we aimed to find a biomarker that can be used in the diagnosis of endometriosis by investigating the serum levels of endocan, which is a substance that we know to have an important role in angiogenesis and inflammation, in patients with endometriosis. STUDY DESIGN: 45 patients between the ages of 18-40 with the diagnosis of stage 3-4 endometriosis and whose postoperative histopathological tissue diagnoses were endometriosis were included in the study as study group. As the control group, a total of 45 healthy women between the ages of 18-40 were included in the study. The two groups were statistically compared. RESULTS: There was no statistically significant difference between the two groups in terms of age, BMI, LH, E2, and mean Hb values. It was observed in the examination of the endocan levels that the mean values in the study (endometriosis, patient group) group were statistically and significantly higher compared to the control (healthy) group (p:0.000). Also, mean FSH and Ca125 levels were determined to be statistically and significantly higher in the endometriosis group (p:0.042 and p:0.000). CONCLUSION: In this study, we found a statistically significant correlation between the levels of serum endocan and endometriosis. As the results, endocan can be used as a new biomarker to diagnose patients with endometriosis or in their follow up period. Much more comprehensive future studies are needed on this subject.