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This study evaluated the impact of three distinct hemostatic techniques—suture, electric coagulation, and ultrasonic scalpel—on ovarian function following laparoscopic enucleation of endometriosis cysts. Researchers analyzed 200 patients with stage I and II disease, measuring follicle-stimulating hormone levels, antibody forming cells, and ovarian stromal artery blood flow at multiple intervals up to one year post-surgery. The results indicated that while all methods affected ovarian markers, the suture group demonstrated significantly better preservation of ovarian function compared to the thermal ablation groups throughout the follow-up period. This paper is centrally about endometriosis — specifically assessing surgical outcomes for ovarian endometriosis cysts.
Abstract
Objective
To explore the effect of different hemostatic methods on ovarian function in laparo-scopic ovarian endometriosis cyst enucleation.
Methods
200 cases of stage I and II ovarian endometriosis cyst admitted to our hospital from Jan. 2012 to Apr. 2014 were selected. All patients underwent conventional laparoscopic ovarian endometrial endometriosis cyst enucleation. According to intraoperative hemostasis methods, patients were divided into 3 groups: suture group(n=70), electric coagulation group(n=70), and ultrasonic scalpel group(n= 60). Follicle-stimulating hormone(FSH)and antibody forming cells(AFC)on admission and at 1, 3, 6, and 12 months after surgery were recorded. Peak systolic blood flow of ovarian stromal artery(PSV)was also observed.
Results
FSH for all the three groups were improved compared with that on admission, and the difference had statistical significance(P 0.05). however, AFC of the suture group at 3, 6, and 12 months after surgery was significantly improved compared with those of the the electric coagulation group and ultrasound knife group. The difference had statistical significance(P< 0.05). Vaginal type B ultrasonic examination after operation showed that PSV of the suture group was higher than that of the electric coagulation group and ultrasound knife group at the second menstruation and at the 6-month menstruation after surgery. The difference of PSV between the 3 groups had statistical significance(P<0.05).
Conclusion
Compared electric coagulation hemostasis and ultrasonic scalpel hemostasis, the suture method can reduce damage of ovarian function in patients with ovarian endometriosis cyst, which is worth to promote.
Key words:
Endometriosis; Ovarian cyst; Hemostasis; Ovarian function
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腹腔镜子宫内膜异位症卵巢囊肿剥除术中不同止血方法对卵巢功能影响
Effect of different hemostatic methods on ovarian function for patients undergoing laparoscopic ovarian endometriosis cyst enucleation
摘要目的：探讨不同止血方法在腹腔镜下子宫内膜异位症卵巢囊肿剥除术中对患者卵巢功能影响。方法选择2012年1月至2014年4月来浙江省绍兴市人民医院进行治疗的子宫内膜异位卵巢囊肿I、II 期200例，患者均进行常规腹腔镜卵巢囊肿剥除术，按照术中止血方式分为缝合组（n=70）、电凝组（n=70）、超声刀组（n=60）。观察患者入院时及术后1、3、6及12个月促卵泡激素（follicle stimulating hormone， FSH）、抗体形成细胞（antibody forming cells，AFC）变化情况及卵巢基质动脉血流的收缩期峰值（peak systolic blood flow of ovarian stromal artery，PSV）结果。结果术后3组FSH较入院时均有提高，与入院时比较差异有统计学意义（P<0.05）；术后1、3、6及12个月时，缝合组FSH明显低于电凝组和超声刀组，3组不同时间FSH变化差异有统计学意义（P<0.05）；术后1个月，3组的AFC差异无统计学意义（P＞0.05）；但术后3、6及12个月缝合组的AFC较电凝组和超声刀组都有明显提高，3组不同时间AFC变化差异有统计学意义（P<0.05）；术后阴道B超显示3组术后第2次月经及术后6个月月经时缝合组的PSV均高于电凝组和超声刀组，3组之间PSV差异有统计学意义（P<0.05）。结论腹腔镜下子宫内膜异位症卵巢囊肿剥除手术中采用电凝和超声刀止血对患者卵巢功能影响较大，相对而言缝合法能减小卵巢功能伤害，值得推广使用。
更多相关知识
abstractsObjective To explore the effect of different hemostatic methods on ovarian function in la-paroscopic ovarian endometriosis cyst enucleation. Methods 200 cases of stage I and II ovarian endometriosis cyst admitted to our hospital from Jan. 2012 to Apr. 2014 were selected. All patients underwent conventional la-paroscopic ovarian endometrial endometriosis cyst enucleation. According to intraoperative hemostasis methods, patients were divided into 3 groups: suture group (n=70), electric coagulation group (n=70), and ultrasonic scalpel group (n=60). Follicle-stimulating hormone (FSH) and antibody forming cells (AFC) on admission and at 1, 3, 6, and 12 months after surgery were recorded. Peak systolic blood flow of ovarian stromal artery (PSV) was also observed. Results FSH for all the three groups were improved compared with that on admission, and the difference had statistical significance (P<0.05). FSH for the suture group was significantly lower than that in the electric coagulation group and ultrasound knife group at 1, 3, 6, and 12 months after operation. The difference had statistical significance (P0.05). however, AFC of the suture group at 3, 6, and 12 months after surgery was significantly im-proved compared with those of the the electric coagulation group and ultrasound knife group. The difference had statistical significance (P<0.05). Vaginal type B ultrasonic examination after operation showed that PSV of the su-ture group was higher than that of the electric coagulation group and ultrasound knife group at the second menstru-ation and at the 6-month menstruation after surgery. The difference of PSV between the 3 groups had statistical significance (P<0.05). Conclusion Compared electric coagulation hemostasis and ultrasonic scalpel hemostasis, the suture method can reduce damage of ovarian function in patients with ovarian endometriosis cyst, which is worth to promote.
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