Impact of haemostatic sealant versus electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy of ovarian endometriomas: a randomised controlled trial.
BJOG
; 126(10): 1267-1275, 2019 Sep.
Article
in En
| MEDLINE
| ID: mdl-31038276
ABSTRACT
OBJECTIVE:
To evaluate the effect of haemostatic sealant compared with bipolar coagulation on ovarian reserve after laparoscopic cystectomy for ovarian endometriomas.DESIGN:
Patient-blinded, randomised controlled trial.SETTING:
University-affiliated tertiary hospital. POPULATION Women aged 18-40 years with 3-8 cm unilateral or bilateral endometriomas.METHODS:
Ninety-four patients were randomised to receive haemostasis by the application of haemostatic sealant (n = 47) or standard care (n = 47). MAIN OUTCOMEMEASURES:
Primary outcome was the effect on the antral follicular count 3 months after the operation as it captures the effect on the ovary subjected to treatment. Secondary outcomes included the change in anti-Mullerian hormone, follicular-stimulating hormone and peri-operative outcomes including haemostasis, complications, pain, and satisfaction scores.RESULTS:
A total of 94 patients aged 32.36 ± 4.92 years underwent laparoscopic cystectomy for ovarian endometriomas. The average diameter of the endometrioma was 4.21 ± 1.38 cm. The increase in antral follicle count of the affected ovaries at 3 months in the intervention group (+2.36 ± 0.37) was significantly (P = 0.013) higher than that in the control group (+1.08 ± 0.36). Repeated measures analysis of variance revealed significant effect with time (P < 0.001) and of interaction of group × time (P = 0.029) for affected ovary antral follicle count. No significant difference was noted between the two groups with regard to follicular-stimulating hormone, anti-Mullerian hormone, and other secondary outcomes.CONCLUSIONS:
Applying haemostatic sealant after laparoscopic cystectomy of ovarian endometriomas produced a greater increase in antral follicle count 3 months after surgery compared with the control group. TWEETABLE ABSTRACT RCT Haemostatic sealant in laparoscopic cystectomy of endometriomas increase in the antral follicle count after surgery.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ovarian Neoplasms
/
Teratoma
/
Tissue Adhesives
/
Cystectomy
/
Laparoscopy
/
Electrocoagulation
/
Fertility Preservation
/
Hemostasis
Type of study:
Clinical_trials
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
BJOG
Journal subject:
GINECOLOGIA
/
OBSTETRICIA
Year:
2019
Document type:
Article