Comparison of hemostatic sealants on ovarian reserve during laparoscopic ovarian cystectomy
Comparison of hemostatic sealants on ovarian reserve during laparoscopic ovarian cystectomy
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DOI：
10.1016/j.ejogrb.2015.08.010
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发表时间：
2015-11-01
影响因子：
2.6
通讯作者：
Kim, Woo Young
中科院分区：
文献类型：
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作者：
Kang, Jun Hyeok;Kim, Yong Seok;Kim, Woo Young
目的：确定不同的止血方法和病理亚型是否会导致腹腔镜卵巢囊肿切除术后卵巢储备功能的显着差异。研究设计：前瞻性收集 129 例接受腹腔镜卵巢囊肿切除术并使用止血密封剂（FloSeal 或 TachoSil）或双极电凝止血的患者的数据。通过酶免疫测定法测定血清抗苗勒氏管激素 (AMH) 水平。每组 [双极凝固器组 (n = 43)、FloSeal 组 (n = 46) 和 TachoSil 组 (n = 40)] 在术前和术后 3 个月进行测量。结果：三组患者的年龄、BMI、产次、社会人口统计学变量和术前 AMH 水平相似。术后 3 个月，双极电凝组的 AMH 下降率显着高于两个止血封闭剂组（分别为 41.2% [IQR，16.7-52.41 vs. 15.4% [IQR，5.2-41.9]；P = 0.003）。然而，两个止血封闭剂组（FloSeal 和 TachoSil）的 AMH 下降率没有显着差异（15.4% [IQR, 7.8-44.61 vs. 15.9% [IQR, 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，无论采用哪种止血方法，血清 AMH 下降率均无显着差异（双极组，P = 0.30；FloSeal 组，P = 0.47，TachoSil 组，P = 0.79）。结论：无论卵巢囊肿类型如何，两种止血封闭剂（FloSeal 和 Tachosil）在保存卵巢储备方面没有表现出任何显着差异。 (C) 2015 Elsevier Ireland Ltd. 保留所有权利。
Objective: To determine whether different methods of hemostasis and pathologic subtypes would lead to significant differences regarding ovarian reserve after laparoscopic ovarian cystectomy.Study design: 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-Mullerian 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)].Results: 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, 16.7-52.41 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, 7.8-44.61 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).Conclusion: The two hemostatic sealants (FloSeal and Tachosil) did not exhibit any significant differences regarding the preservation of ovarian reserve regardless of ovarian cyst type. (C) 2015 Elsevier Ireland Ltd. All rights reserved.