Evidence map›Paper›PMID 41914717›Full record

SynthesisActa obstetricia et gynecologica Scandinavica2026

The effect of temporary uterine artery ligation on blood loss during laparoscopic myomectomy: A systematic review and meta-analysis.

Maria M Witkowiak, Natalie E Bourdakos, Zoe Y Zervides, Olga Moutzouri, Marisa M Dariotis, Liranne Bitton, Fatma A M Abdulsalam, Hayato Nakanishi, Christian A Than, Anna Abacjew-Chmylko

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Maria M WitkowiakSchool of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.ORCID 0009-0001-1068-7155
Natalie E BourdakosSchool of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
Zoe Y ZervidesSchool of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
Olga MoutzouriSchool of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
Marisa M DariotisSchool of Medicine, St George's University of London, London, UK.
Liranne BittonSchool of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
Fatma A M AbdulsalamDepartment of Medicine, Oxford University Hospitals NHS Foundation Trust of Headley Way, Oxford, UK.
Hayato NakanishiDepartment of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Christian A ThanCambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, UK.
Anna Abacjew-ChmylkoDepartment of Gynecology and Obstetrics, Medical University of Gdansk, Gdansk, Poland.ORCID 0000-0002-0716-9664

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe effectiveness of temporary uterine artery ligation (TUAL) in reducing blood loss during laparoscopic myomectomy (LM) is uncertain, despite increased use as an adjunct to improve surgical safety. This study aims to evaluate the safety and efficacy of TUAL in LM for the management of uterine myomas. MATERIAL AND

methodsWe conducted a systematic review and meta-analysis of comparative studies evaluating LM with and without TUAL. Electronic databases were searched up to October 7, 2024. Eligible studies were randomized controlled trials or observational comparative studies published in English that reported at least one primary outcome. The primary outcomes were intraoperative estimated blood loss and perioperative change in hemoglobin. Secondary outcomes included operative time, number and size of myomas removed, length of hospital stay, recurrence, and complication rates. Data extraction and analysis were performed using a random-effects model. This review was registered prospectively with PROSPERO (CRD42024595684).

resultsSeven studies met the inclusion criteria, comprising five randomized controlled trials and two retrospective case-control studies, with a total of 857 women (352 undergoing LM with TUAL and 505 undergoing LM alone). TUAL was associated with a reduction in intraoperative estimated blood loss (mean difference [MD]: -84.7 mL; 95% Cl: -89.0; -80.0) and postoperative reduction in hemoglobin level (MD: -0.4 g/dL; 95% Cl: -0.7; -0.2) compared with LM without TUAL. However, TUAL was associated with increased operative time (MD: 16.5 min; 95% Cl: 3.4; 29.6).

conclusionsTUAL appears to be a possible adjunct to LM for selected patients in the management of uterine myomas. Our study demonstrated that TUAL with LM could be associated with a reduction in estimated blood loss, despite an increase in operative time. Nonetheless, further studies with a larger sample size and long-term follow-up, as well as stratification of outcomes based on ligation technique, are warranted to elucidate the benefits of TUAL.

Indexed as

Blood Loss, SurgicalLaparoscopyLeiomyomaUterine ArteryUterine MyomectomyUterine NeoplasmsFemaleHumansLigationintraoperative bleedinglaparoscopic myomectomymeta‐analysismyomastemporary uterine artery ligationTUAL

Identifiers

PMID41914717
PMCPMC13125364

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.