Does ligation of the hypogastric artery at the time of radical hysterectomy and lymphadenectomy decrease blood loss? Results of a prospective randomized trial

A prospective, randomized study of patients undergoing radical hysterectomy for gynecologic malignancies was undertaken from 10/95 to 11/96 to determi ne if ligation of the hypogastric arteries at the time of radical hysterect omy decreases blood loss. Patients were randomized to either ligation of th e hypogastric artery (Group 1) or no ligation (Group 2) prior to a standard Fiver type III radical hysterectomy. Surgeries were performed by Board cer tified gynecologic oncologists with gynecologic oncology fellows and/or OB/ GYN residents. Patients were analyzed for demographic characteristics and i ntraoperative and postoperative parameters. Statistical analysis was perfor med with independent samples t-test, Mann-Whitney rank sum test, Chi square and Fisher exact test. Twenty-one patients were randomized to group 1 and 22 to group 2. Groups were similar with respect to demographics and preoper ative parameters except for age. There were no differences among the groups with respect to intraoperative and postoperative parameters. The mean esti mated blood loss for group 1 was 600 mi and 550 mi for group 2 (P = NS). Hy pogastric artery ligation (HAL) at the time of radical hysterectomy for gyn ecologic malignancy does not reduce blood loss.