Decrease Blood Loss Following Open Myomectomy Using Modified B-Lynch Suture

Objectives: To assess the efficacy of the hemostatic action of modified B-Lynch sutures following open myomectomy. Methods: This randomized clinical trial included 480 women, with multiple fibroid uteri and uterine sizes equivalent to 16-20 weeks undergoing open myomectomy in Ain Shams University Maternity Hospital from March 2013 to March 2015. Women were divided into two groups. Group I (240 women) operated upon by routine myomectomy while group II (240 patients) operated upon by modified B-Lynch sutures following the routine myomectomy. Data were gathered, after computer generated randomization, including the age, parity, weight, preoperative vital data, duration of the operation, complications (intraoperative bleeding, bleeding from multiple bites, fever, wound infection) pre and 3rd day postoperative complete blood count, need for blood transfusion, postoperative vital data, amount of intraoperative blood loss as estimated by the acute normovolemic hemodulation technique and postoperative blood loss as measured by the blood collected in the suction drain. Results: There was a significant difference between the two groups as regards the average intraoperative blood loss (679.9±0.71 ml group I and 371.5±0.23 ml in group II respectively). The average postoperative blood loss in group I was 270±95 ml and 98±58 ml in group II with significant difference between the two groups. Conclusion: Modified B-Lynch suture is effective in decreasing blood loss during and after the open myomectomy and also decrease the postoperative hospital stay. So it is recommended to be done routinely in case of large uteri with multiple fibrosis.