Comparison of hemostatic sealants on ovarian reserve during laparoscopic ovarian cystectomy

Abstract

ObjectiveTo determine whether different methods of hemostasis and pathologic subtypes would lead to significant differences regarding ovarian reserve after laparoscopic ovarian cystectomy. Study designData 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)]. ResultsAge, 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). ConclusionThe two hemostatic sealants (FloSeal and Tachosil) did not exhibit any significant differences regarding the preservation of ovarian reserve regardless of ovarian cyst type.