Abstract
The aim of the study was to analyze the effect of surgical intervention on the status of the ovarian follicular apparatus in patients with benign ovarian cystic tumors (BCOTs) based on the results of morphometric studies.Material and methods. The authors have studied surgical material of 60 patients aged 18-47 years with BCOTs: serous cystadenoma (20 cases), serous papillary cystadenoma (7 cases), mucinous cystadenoma (12 cases), mature teratoma (23 cases). Microscopic slides of ovarian tissue stained with hematoxylin and eosin were obtained and morphological structure of BCOTs, presence of the intact ovarian tissue surrounding neoplasm and the density of follicles there were studied based on their qualitative characteristics (maturity, signs of degeneration).Results. It was found out that development of fibrosis in the wall of BCOTs significantly depends on the tumor histogenesis: the greatest thickness of fibrosis was detected in serous papillary cystadenomas, the smallest in the group of mature teratomas, the average values were determined in mucinous and serous cystadenomas of the ovaries. The influence of BCOTs on the ovarian reserve does not depend on its morphological structure, localization and diameter. The intact ovarian tissue is removed along with BCOTs during adnexectomy, ovarian resection and in 48.8% of cases – during cystectomy. During cystectomy, probability of the perifocal intact ovarian tissue presence is reduced due to the growth of fibrous tissue in this area. However, the negative impact of BCOTs on the ovarian reserve occurs not only due to surgical removal of the ovarian tissue, but also as a result of inhibition of folliculogenesis at the preoperative stage.Conclusion. BCOTs of the presented morphological groups negatively affect the follicular apparatus due to both – inhibition of folliculogenesis at the preoperative stage and loss of ovarian tissue during surgery. More pronounced perifocal proliferation of fibrous tissue was noted with serous papillary cystadenomas.
Highlights
Целью настоящего исследования явилось изучение влияния проведенного хирургического вмешательства у пациенток с доброкачественными кистозными опухолями яичников (ДКОЯ) на состояние фолликулярного аппарата на основании морфометрического исследования
The aim of the study was to analyze the effect of surgical intervention on the status of the ovarian follicular apparatus in patients with benign ovarian cystic tumors (BCOTs) based on the results of morphometric studies
It was found out that development of fibrosis in the wall of BCOTs significantly depends on the tumor histogenesis: the greatest thickness of fibrosis was detected in serous papillary cystadenomas, the smallest in the group of mature teratomas, the average values were determined in mucinous and serous cystadenomas of the ovaries
Summary
Целью настоящего исследования явилось изучение влияния проведенного хирургического вмешательства у пациенток с доброкачественными кистозными опухолями яичников (ДКОЯ) на состояние фолликулярного аппарата на основании морфометрического исследования. Нами был исследован операционный материал 60 пациенток в возрасте от 18 до 47 лет с ДКОЯ: серозной цистаденомой (20 наблюдений), серозной папиллярной цистаденомой (7), муцинозной цистаденомой (12), зрелой тератомой (23). Влияние на овариальный резерв со стороны ДКОЯ не зависит от его морфологического строения, локализации и диаметра опухолевого образования. При проведении последнего типа операции вероятность присутствия перифокально интактной ткани яичника снижается за счет разрастания в этой области фиброзной ткани. Однако негативное влияние на овариальный резерв со стороны ДКОЯ осуществляется не только за счет удаления ткани яичника в ходе оперативного вмешательства, но и в результате угнетения фолликулогенеза на дооперационном этапе. ДКОЯ представленных морфологических групп негативно влияют на фолликулярный аппарат как за счет угнетения фолликулогенеза на дооперационном этапе, так и вследствие потери ткани яичника в ходе оперативного вмешательства. The aim of the study was to analyze the effect of surgical intervention on the status of the ovarian follicular apparatus in patients with benign ovarian cystic tumors (BCOTs) based on the results of morphometric studies
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