Fertility and sterility · 2012
Mesial side ovarian incision for laparoscopic dermoid cystectomy: a safe and ovarian tissue-preserving technique.
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Morelli Michele, Mocciaro Rita, Venturella Roberta, Imperatore Alberto, Lico Daniela, Zullo Fulvio
Аннотация
OBJECTIVE: To evaluate safety and efficacy, in terms of spillage risk and ovarian tissue preservation, of mesial incision for laparoscopic dermoid cystectomy.
DESIGN: Randomized controlled trial.
SETTING: University.
PATIENT(S): Sixty-seven women with dermoid cysts.
INTERVENTION(S): Laparoscopic dermoid cystectomy performed by mesial incision (33 patients, study group) or antimesial incision (34 patients, control group).
MAIN OUTCOME MEASURE(S): Spillage of intracystic content rate, operative times, chemical peritonitis rate, and intraoperative blood loss (ΔHb) as primary outcomes. Postoperative ovarian reserve (ΔFSH levels, basal antral follicle number, mean ovarian diameter, and peak systolic velocity at 3 and 12 months after surgery) as secondary outcome.
RESULT(S): Spillage of intracystic content rate and operative time were significantly lower in the study than in the control group. None developed chemical peritonitis. ΔHb was higher in the study group but not significantly. During the follow-up, median FSH values were significantly lower in the study group, with no differences in the E(2) levels. Moreover, median basal antral follicle number, median ovarian diameter, and median peak systolic velocity were significantly higher in the study group.
CONCLUSION(S): Ovarian mesial-side incision appears to be a safe as well as tissue-sparing technique.
DESIGN: Randomized controlled trial.
SETTING: University.
PATIENT(S): Sixty-seven women with dermoid cysts.
INTERVENTION(S): Laparoscopic dermoid cystectomy performed by mesial incision (33 patients, study group) or antimesial incision (34 patients, control group).
MAIN OUTCOME MEASURE(S): Spillage of intracystic content rate, operative times, chemical peritonitis rate, and intraoperative blood loss (ΔHb) as primary outcomes. Postoperative ovarian reserve (ΔFSH levels, basal antral follicle number, mean ovarian diameter, and peak systolic velocity at 3 and 12 months after surgery) as secondary outcome.
RESULT(S): Spillage of intracystic content rate and operative time were significantly lower in the study than in the control group. None developed chemical peritonitis. ΔHb was higher in the study group but not significantly. During the follow-up, median FSH values were significantly lower in the study group, with no differences in the E(2) levels. Moreover, median basal antral follicle number, median ovarian diameter, and median peak systolic velocity were significantly higher in the study group.
CONCLUSION(S): Ovarian mesial-side incision appears to be a safe as well as tissue-sparing technique.
Предметные рубрики MeSH
BiomarkersBlood Loss, SurgicalChi-Square DistributionFemaleFertility PreservationFollicle Stimulating Hormone, HumanGynecologic Surgical ProceduresHumansLaparoscopyOrgan Sparing TreatmentsOvarian FollicleOvarian NeoplasmsOvaryPeritonitisRisk AssessmentRisk FactorsTeratomaTime FactorsTreatment OutcomeUltrasonography