Prévention De L’hémorragie Per Myomectomie En Afrique Subsaharienne : Apport Du Garrot Sur L’isthme Utérin

Objectives. - To appreciate the decrease of bleeding by myomectomy by the use of a tourniquet on the uterine isthmus. Methods. - We conducted a case-control retrospective study from March 2014 to February 2016 in the Gynecology and obstetrics Department of the university hospital of Yopougon (Abidjan, Ivory Coast). It interested 100 patients of which 50 had a myomectomy with the tourniquet on the uterine isthmus and 50 without the tourniquet. None of the patients received pre-operative preventive treatment. The criteria for comparison were the blood loss per operative and the pre-and post-operative hemoglobin levels. Results. - The average age of patients was 33 years. Nulliparous women were the group most affected (68% of our patients) with 32% infertile women in the group with the tourniquet and 18% in the group without the tourniquet. Patients without tourniquet presented more bleeding than patients with tourniquet (X2 = 13.61) with a higher proportion of anemic patients in the group without the tourniquet. The differences were significant. The tourniquet has made it possible to realize the resection of a larger number of myoma. The duration of hospital stay was 4 days on average in both groups and no complications were observed. Conclusions. - The application of a tourniquet on the uterine isthmus during laparotomic myomectomy has a benefit in reducing intraoperative blood loss. (C) 2018 Elsevier Masson SAS. All rights reserved.