Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan.
Clinical Trial Center, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.
BMC Surg. 2021 Jan 21;21(1):49. doi: 10.1186/s12893-021-01061-1.
To evaluate the use of a human fibrin glue (Tisseel) for minor bleeding control and approximation of ovarian defect during transvaginal natural orifice ovarian cystectomy (TNOOC) of benign and non-endometriotic ovarian tumors.
A total of 125 women with benign and non-endometriotic ovarian tumors who underwent TNOOC between May 2011 and January 2020: 54 with the aid of Tisseel and 71 with traditional suture for hemostasis and approximation of ovarian defect. Surgical outcomes such as length of surgery, operative blood loss, postoperative pain score, and postoperative hospital stay were recorded. Before and immediately (10 days) and at 6 months after the procedure, serum anti-Müllerian hormone (AMH) levels were also determined.
Complete hemostasis and approximation of ovarian defect were achieved in all cases. No significant difference was noted in the operating time, operative blood loss, postoperative pain scores after 12, 24 and 48 h, length of postoperative stay, and baseline AMH levels between the two groups. The operation did not have a negative effect on the immediate and 6-month postoperative AMH levels in the suture group. However, the decline in the AMH levels was significant immediately after surgery in the Tisseel group, nevertheless, no significant difference was noted in the AMH levels at 6 months (3.3 vs. 1.7 mg/mL; p = 0.042, adjusted p = 0.210).
The use of Tisseel in TNOOC of benign and non-endometriotic ovarian tumors without suturing the ovarian tissue is clinically safe and feasible.
评估使用人纤维蛋白胶（Tisseel）控制经阴道自然腔道卵巢囊肿切除术（TNOOC）中良性和非子宫内膜异位性卵巢肿瘤的小出血和卵巢缺陷的接近。
2011 年 5 月至 2020 年 1 月期间，125 名患有良性和非子宫内膜异位性卵巢肿瘤的妇女接受了 TNOOC：54 名妇女使用 Tisseel，71 名妇女使用传统缝线进行止血和卵巢缺陷接近。记录手术结果，如手术时间、手术失血量、术后疼痛评分和术后住院时间。在术前和术后即刻（10 天）和 6 个月，还测定血清抗苗勒管激素（AMH）水平。
所有病例均实现完全止血和卵巢缺陷接近。两组间手术时间、手术失血量、术后 12、24 和 48 小时疼痛评分、术后住院时间和基线 AMH 水平无显著差异。缝线组的手术对即时和 6 个月术后 AMH 水平没有负面影响。然而，Tisseel 组术后 AMH 水平立即下降，但在 6 个月时无显著差异（3.3 与 1.7 mg/ml；p=0.042，调整后 p=0.210）。
在不缝合卵巢组织的情况下，TNOOC 中使用 Tisseel 是安全可行的。
