Protective effect of laparoscopic removal of water and suture hemostasis on ovarian function

Abstract

Objective To investigate the protective effect of laparoscopic water separation and removal combined with suture hemostasis on ovarian reserve function after bilateral ovarian endometriotic cyst (OEC) stripping. Methods From January 2016 to January 2018, 60 patients with bilateral ovarian endometriosis cystectomy underwent laparoscopic surgery in the Department of Obstetrics and Gynecology, Jiading Hospital of traditional Chinese medicine.According to the random number table method, they were divided into study group (water separation and stripping combined suture hemostasis group) and the control group (direct stripping combined with electrocoagulation hemostasis group), 30 cases in each group.The changes of operation time, hemoglobin level before and after operation and the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti Mullerian hormone (AMH) were compared between the two groups. Results There was no significant difference in operation time (47.52 ±10.11) min, hemoglobin decrease (0.55 ±0.26) g/L, hospital stay (6.1 ±0.3) d, control group (48.01 ±10.24) min, hemoglobin decrease (0.56 ±0.25) g/L and hospitalization time (6.2 ±0.4) d before and after operation (t=0.056, 0.964, 0.863, all P>0.05). The levels of FSH, E2, LH and AMH in the study group before operation were (6.15 ±2.31) U/L, (152.41 ±41.40) nmol/L, (5.44 ±1.52) U/L and (2.21 ±0.13) μg/L, respectively.One month after operation, they were(6.21±2.24) U/L, (150.63±40.33) nmol/L, (5.13±1.58) U/L, (2.18±0.16) μg/L, respectively.Three months after operation, they were (6.52±2.41) U/L, (149.57±42.37) nmol/L, (5.30±1.45) U/L, (2.17± 0.15) μg/L, respectively.Six months after operation, they were (6.53±2.44) U/L, (151.36±41.54) nmol/L, (4.98±1.61) U/L, (2.20±0.08) μg/L, respectively.The levels of FSH, E2, LH and AMH in the control group before operation were (6.14±2.21) U/L, (153.31±40.39) nmol/L, (5.51±1.46) U/L, (2.23±0.13) μg/L, respectively.One month after operation, they were (8.11±2.44) U/L, (131.43±41.23) nmol/L, (5.92±1.64) U/L, (1.58±0.14) μg/L, respectively.Three months after operation, they were (8.42±2.35) U/L, (135.67±40.38) nmol/L, (6.12±1.51) U/L, (1.54±0.16) μg/L, respectively.Six months after operation, they were (9.17±2.64) U/L, (133.66±40.44) nmol/L, (6.28±1.74) U/L, (1.51±0.13) μg/L, respectively.There was no significant difference in the levels of FSH, E2, LH and AMH between the two groups (all P>0.05). There was significant difference between the preoperative FSH level and the postoperative 1, 3, 6 months in the control group (all P<0.05); there was significant difference between the preoperative E2 level and the postoperative 1 month in the control group (P<0.05); there was statistical significance between the preoperative AMH level and the postoperative 1, 3 months in the control group (all P<0.05). The levels of FSH, LH, E2 and AMH in the study group were significantly higher than those in the control group (all P<0.05). Conclusion Laparoscopic hydrodissection combined with suture hemostasis does not increase the operation time and the amount of bleeding, and does not affect the ovarian reserve function after operation. Key words: Ovarian endometrioma; Hydrodissection; Suture hemostasis; Ovarian reserve function