PubMed · 15535225
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Ken Sugiura, Hisamori Kato, Ryo Onose, Motohiro Shimizu, Takashi Yamada, Haruya Saji, Hiroki Nakayama. 2004. [Laser conization].. https://pubmed.ncbi.nlm.nih.gov/15535225/
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OBJECTIVE: To review the clinical evidence for the use of recombinant factor VIIa (rFVIIa) in the prevention and/or treatment of bleeding in non-hemophiliac patients. DATA SOURCES: A MEDLINE search (1966-December 2004) was conducted to identify pertinent literature. Results were limited to English-language reports and clinical trials. References of relevant articles and selected abstracts presented at scientific meetings were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Human data from prospective and retrospective studies that examined the hemostatic effect of rFVIIa in non-hemophiliac patients were reviewed, with a focus on surgical prophylaxis, liver disease, intractable bleeding associated with trauma and surgery, and anticoagulation reversal. DATA SYNTHESIS: Results from limited controlled trials on the use of rFVIIa as an adjunct for prevention of bleeding in surgery and liver diseases have not been consistent. For treatment of intractable bleeding, earlier use of rFVIIa in one trauma trial was shown to decrease the number of blood transfusions, but no differences in terms of clinical outcomes were observed in all trials. Controlled trials do not suggest an increased risk of thrombotic events. Optimal dosing and timing of administration have yet to be defined. CONCLUSIONS: Until further prospective controlled data are available, it is recommended that conventional intervention for prevention and control of hemorrhage in non-hemophiliac patients should remain the standard of care. Close monitoring of coagulation parameters is recommended before, during, and after therapy, especially in high-risk patients. Pharmacoeconomic analysis may be useful to help control costs and maximize clinical benefits.
Tension-free vaginal tape (TVT) is a well-established surgical procedure for the treatment of female urinary stress incontinence. The operation, described by Ulmsten in 1995, is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimally invasive surgical technique. Intraoperative bleeding was described as complicating former surgical methods for correction of female urinary stress incontinence as well as TVT. The aim of this paper was to describe a simple transvaginal hemostatic suture placement to control accidental intraoperative hemorrhage. Of 566 patients undergoing TVT and followed for up to 68 months, 9 (1.6%) had intraoperative bleeding of 200-800 ml, all of which were diagnosed and corrected among the first 466 procedures. The last 100 patients had a transvaginal hemostatic suture placed whenever more than minimal bleeding occurred and hemostasis was achieved immediately with all. The benefit of this minimal, fast, and simple surgical step is assessed and discussed.
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