Effect on ovarian reserve of hemostasis by bipolar coagulation versus suture during laparoendoscopic single-site cystectomy for ovarian endometriomas.
J Minim Invasive Gynecol
; 22(3): 415-20, 2015.
Article
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| MEDLINE
| ID: mdl-25460517
ABSTRACT
STUDY OBJECTIVE:
To compare the postoperative decrease in ovarian reserve between hemostasis by bipolar coagulation and suture during laparoendoscopic single-site cystectomy (LESS-C) for ovarian endometriomas.DESIGN:
Prospective comparative study (Canadian Task Force Classification II-1).SETTING:
University hospital. PATIENTS One hundred twenty-five patients with ovarian endometriomas.INTERVENTIONS:
Patients with endometrioma were managed by hemostasis with either bipolar coagulation (n = 62) or suturing (n = 63) during LESS-C. We evaluated the impact of surgery on ovarian reserve using serum anti-Müllerian hormone (AMH) levels, which were measured before surgery and 3 months after surgery in all patients. MEASUREMENT AND MAINRESULTS:
Baseline characteristics such as age, bilaterality of endometriomas, and preoperative AMH levels were similar between the 2 study groups. There were also no differences between the 2 groups in surgical outcomes, such as operative time, operative blood loss, or operative complications. In both study groups, postoperative AMH levels were lower than preoperative AMH levels (p < .001). The decline rate of AMH levels was significantly greater in the bipolar coagulation group than in the suture group (42.2% [interquartile range, 16.5%-53.0%] and 24.6% [interquartile range, 11.6%-37.0%], respectively, p = .001).CONCLUSION:
Hemostasis by bipolar coagulation after stripping of the endometrioma during LESS-C reduces ovarian reserve more than suturing does, as determined by serial AMH levels. Therefore, suturing may be a better hemostatic choice after stripping ovarian endometriomas.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedades del Ovario
/
Técnicas de Sutura
/
Electrocoagulación
/
Endometriosis
/
Hormona Antimülleriana
/
Reserva Ovárica
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Female
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Minim Invasive Gynecol
Asunto de la revista:
GINECOLOGIA
Año:
2015
Tipo del documento:
Article