Kang Jun Hyeok, Kim Yong Seok, Lee San Hui, Kim Woo Young
Department of Obstetrics & Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Obstetrics & Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Eur J Obstet Gynecol Reprod Biol. 2015 Nov;194:64-7. doi: 10.1016/j.ejogrb.2015.08.010. Epub 2015 Aug 20.
To determine whether different methods of hemostasis and pathologic subtypes would lead to significant differences regarding ovarian reserve after laparoscopic ovarian cystectomy.
Data were prospectively collected from 129 patients who underwent laparoscopic ovarian cystectomy with either a hemostatic sealant (FloSeal or TachoSil) or bipolar coagulation to achieve hemostasis. Serum anti-Müllerian hormone (AMH) levels as measured by enzyme immunoassay. Measurements were made preoperatively and at 3 months postsurgery in each group [bipolar coagulator group (n=43), FloSeal group (n=46), and TachoSil group (n=40)].
Age, BMI, parity, sociodemographic variables, and preoperative AMH levels were similar between the three groups of patients. At 3 months post-surgery, the AMH decline rate was significantly greater in the bipolar coagulation group compared with the two hemostatic sealant groups (41.2% [IQR, 16.7-52.4] vs. 15.4% [IQR, 5.2-41.9], respectively; P=0.003). However, the AMH decline rates of the two hemostatic sealant groups (FloSeal and TachoSil) were not significantly different (15.4% [IQR, 7.8-44.6] vs. 15.9% [IQR, 0.7-41.1], P=0.962). Also, subgroup analysis according to ovarian cyst type revealed no significant differences in the rate of serum AMH decline regardless of the hemostatic method (bipolar group, P=0.30; FloSeal group, P=0.47, and TachoSil group, P=0.79).
The two hemostatic sealants (FloSeal and Tachosil) did not exhibit any significant differences regarding the preservation of ovarian reserve regardless of ovarian cyst type.
确定在腹腔镜卵巢囊肿切除术后，不同的止血方法和病理亚型是否会导致卵巢储备功能出现显著差异。
前瞻性收集了129例行腹腔镜卵巢囊肿切除术患者的数据，这些患者使用止血密封剂（FloSeal或TachoSil）或双极电凝进行止血。采用酶免疫分析法测定血清抗苗勒管激素（AMH）水平。在每组（双极电凝组，n = 43；FloSeal组，n = 46；TachoSil组，n = 40）的患者术前及术后3个月进行测量。
三组患者的年龄、体重指数、产次、社会人口统计学变量及术前AMH水平相似。术后3个月，双极电凝组的AMH下降率显著高于两种止血密封剂组（分别为41.2%[四分位间距，16.7 - 52.4] vs. 15.4%[四分位间距，5.2 - 41.9]；P = 0.003）。然而，两种止血密封剂组（FloSeal和TachoSil）的AMH下降率无显著差异（15.4%[四分位间距，7.8 - 44.6] vs. 15.9%[四分位间距，0.7 - 41.1]，P = 0.962）。此外，根据卵巢囊肿类型进行的亚组分析显示，无论采用何种止血方法，血清AMH下降率均无显著差异（双极电凝组，P = 0.30；FloSeal组，P = 0.47；TachoSil组，P = 0.79）。
无论卵巢囊肿类型如何，两种止血密封剂（FloSeal和Tachosil）在保留卵巢储备功能方面均未表现出任何显著差异。
