Ovarian reserve and recurrence 1 year post-operatively after using haemostatic sealant and bipolar diathermy for haemostasis during laparoscopic ovarian cystectomy
| Autor: | Tin-Chiu Li, Tracy Sze Man Law, Jennifer Sze Man Mak, Daljit Singh Sahota, Jacqueline Pui Wah Chung |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult endocrine system medicine.medical_specialty Adolescent medicine.medical_treatment Endometriosis Laparoscopic ovarian cystectomy Hemostatics law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial law Interquartile range Diathermy Medicine Humans Ovarian Diseases Postoperative Period Ovarian reserve Ovarian Reserve 030219 obstetrics & reproductive medicine business.industry Hemostatic Techniques Sealant Obstetrics and Gynecology Antral follicle Gelatin Sponge Absorbable Surgery Ovarian Cysts 030104 developmental biology Treatment Outcome Reproductive Medicine Relative risk Hong Kong Female Laparoscopy Neoplasm Recurrence Local business Developmental Biology Follow-Up Studies |
| Zdroj: | Reproductive biomedicine online. 43(2) |
| ISSN: | 1472-6491 |
| Popis: | Research question Is there a difference in the ovarian reserve 1 year post-operatively in those who used a haemostatic sealant or bipolar diathermy for haemostasis during laparoscopic ovarian cystectomy for ovarian endometriomas? Design This was an extended follow-up observational study of a previous randomized controlled trial where women aged 18 to 40 years with 3–8 cm unilateral or bilateral endometriomas were randomized to receive haemostasis by a haemostatic sealant or bipolar diathermy following ovarian cystectomy. The primary outcome was the ovarian reserve as assessed by antral follicle count (AFC) 1 year post-operatively. Secondary outcomes included the recurrence rate of ovarian endometrioma, the change in anti-Mullerian hormone (AMH) and FSH concentrations, and reproductive outcomes. Results The significant increase in AFC at 3 months after initial surgery (P = 0.025) in the haemostatic sealant group compared with the diathermy group was sustained at 1 year (P = 0.024) but there was no difference in AMH or FSH concentrations between the groups throughout the follow-up period. The recurrence rate in the FloSeal group was 7.7% (n = 3/39) compared with 22.2% (n = 8/36) in the diathermy group (P = 0.060). The recurrence rate in women who had bilateral lesions was significantly higher than those with unilateral lesions (risk ratio 5.33, interquartile range 1.55–18.38). No difference in reproductive outcomes was found between the two groups. Conclusions Applying haemostatic sealant after laparoscopic cystectomy of ovarian endometriomas produces a significantly greater improvement in AFC, which was apparent at 3-month follow-up, and was sustained at 1-year follow-up without compromising the recurrence rate. |
| Databáze: | OpenAIRE |
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