Abstract
To compare the postoperative decrease in ovarian reserve between hemostasis by bipolar coagulation and suture during laparoendoscopic single-site cystectomy (LESS-C) for ovarian endometriomas. Prospective comparative study (Canadian Task Force Classification II-1). University hospital. One hundred twenty-five patients with ovarian endometriomas. Patients with endometrioma were managed by hemostasis with either bipolar coagulation (n=62) or suturing (n=63) during LESS-C. We evaluated the impact of surgery on ovarian reserve using serum anti-Müllerian hormone (AMH) levels, which were measured before surgery and 3months after surgery in all patients. Baseline characteristics such as age, bilaterality of endometriomas, and preoperative AMH levels were similar between the 2 study groups. There were also no differences between the 2 groups in surgical outcomes, such as operative time, operative blood loss, or operative complications. In both study groups, postoperative AMH levels were lower than preoperative AMH levels (p<.001). The decline rate of AMH levels was significantly greater in the bipolar coagulation group than in the suture group (42.2% [interquartile range, 16.5%-53.0%] and 24.6% [interquartile range, 11.6%-37.0%], respectively, p=.001). Hemostasis by bipolar coagulation after stripping of the endometrioma during LESS-C reduces ovarian reserve more than suturing does, as determined by serial AMH levels. Therefore, suturing may be a better hemostatic choice after stripping ovarian endometriomas.
Published Version
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