Epinephrine minimizes the use of bipolar coagulation and preserves ovarian reserve in laparoscopic ovarian cystectomy: a randomized controlled trial
| Autor: | Seong Jin Choi, Seung Kuy Cha, Kyu Sang Park, Eun Young Park, Kyu Hee Hwang, Ji Hee Kim, San Hui Lee |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Anti-Mullerian Hormone medicine.medical_specialty endocrine system endocrine system diseases Epinephrine Urology Blood Loss Surgical Article law.invention Lesion 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial law parasitic diseases medicine Humans Ovarian reserve Ovarian Reserve Blood Coagulation Hemostasis 030219 obstetrics & reproductive medicine Multidisciplinary Ovarian cyst business.industry Ovary Antral follicle medicine.disease Coagulation Outcomes research 030220 oncology & carcinogenesis Infertility Randomized controlled trials Female Laparoscopy medicine.symptom business medicine.drug |
| Zdroj: | Scientific Reports |
| ISSN: | 2045-2322 |
| Popis: | We propose a novel method, the epinephrine compression method (Epi-pledget), as a hemostasis method for ovarian cystectomy. A total of 179 patients undergoing laparoscopic ovarian cystectomy with stripping were randomly allocated into three groups: the bipolar coagulation group, the Epi-pledget group, and the coagulation after Epi-pledget (Epi & Coagulation) group. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) by ultrasonography were measured to determine the preservation of ovarian function. To evaluate the postoperative ovarian cellular proliferative activity and tissue damage in a mouse model, we operated on the ovaries of mice with an artificial incision injury and applied two hemostatic methods: coagulation and Epi-pledget. Eight weeks after surgery, the AMH rate significantly decreased in the bipolar coagulation group compared with the Epi-pledget group. The AFC decline rate was also significantly greater in the coagulation group than the Epi-pledget group. Specifically, patients with endometrioma had a significantly greater decline of serum AMH in the coagulation group than the Epi-pledget group. In a histopathological analysis in mice, the Epi-pledget group showed ameliorated fibrotic changes and necrotic findings in the injured lesion compared with the bipolar coagulation group. The Epi-pledget method for ovarian stripping has an additional benefit of maximizing the preservation of the ovarian reserve, especially for the endometriotic ovarian cyst type. |
| Databáze: | OpenAIRE |
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