Marwali Luky Satria, Setiawan Marcel Ezra, Emeraldi Malvin, Asadi Agus Surur, Putera Aditya Rangga, Puspitasari Rany Ayu
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Endometriosis Center, Minimally Invasive Surgery Unit, Fatmawati General Hospital, Jakarta, Indonesia.
Gynecol Minim Invasive Ther. 2024 Dec 30;14(1):51-56. doi: 10.4103/gmit.gmit_161_23. eCollection 2025 Jan-Mar.
This study aims to determine the impact of oxidized regenerated cellulose (ORC) during cystectomy and drainage on recurrence and ovarian reserve.
Women aged 18-45 years with endometrioma (pathologically confirmed) who underwent conservative laparoscopy surgery (cystectomy and drainage) using ORC at Fatmawati General Hospital Jakarta, Indonesia, were included in this study. All surgeries were done by complete excision of all endometriosis lesions (especially for excision of deep infiltrating endometriosis and adenomyosis resection). All patients were followed up for 1 year, and the recurrence rate and postoperative anti-Mullerian Hormone (AMH) were evaluated.
Twenty patients were included in the cystectomy group and 19 in the drainage group. The researchers found the result was not significant ( = 0.622) in recurrence rate. AMH was decreased from 3.0 ± 1.8 to 2.1 ± 1.5 in cystectomy with ORC group. Conversely, AMH decreased from 1.4 ± 1.25 to 1.1 ± 0.9 in the drainage with ORC group. The reduction of AMH level was more significant in the cystectomy group ( = 0.002) than in the drainage group ( = 0.124).
Cystectomy with ORC significantly reduces ovarian reserve. Drainage followed by insertion of ORC to the cyst cavity can be an option to maintain ovarian reserve with a risk of recurrence that is not significantly different from cystectomy.
本研究旨在确定氧化再生纤维素（ORC）在膀胱切除术和引流术中对复发及卵巢储备功能的影响。
本研究纳入了年龄在18 - 45岁、患有子宫内膜异位症（经病理确诊）且在印度尼西亚雅加达法塔瓦蒂综合医院接受使用ORC的保守性腹腔镜手术（膀胱切除术和引流术）的女性。所有手术均通过完整切除所有子宫内膜异位症病灶（尤其针对深部浸润性子宫内膜异位症的切除和子宫腺肌病切除术）完成。所有患者均随访1年，评估复发率及术后抗苗勒管激素（AMH）水平。
膀胱切除术组纳入20例患者，引流术组纳入19例患者。研究人员发现复发率方面差异无统计学意义（P = 0.622）。使用ORC的膀胱切除术组中，AMH水平从3.0±1.8降至2.1±1.5。相反，使用ORC的引流术组中，AMH水平从1.4±1.25降至1.1±0.9。膀胱切除术组AMH水平的降低比引流术组更显著（P = 0.002 vs P = 0.124）。
使用ORC进行膀胱切除术会显著降低卵巢储备功能。向囊肿腔内插入ORC后进行引流术可作为维持卵巢储备功能的一种选择，其复发风险与膀胱切除术相比无显著差异。
