title: Which Should Be the Preferred Technique During Laparoscopic Ovarian Cystectomy.
abstract: The aim of the present study was to determine the long-term effects of different laparoscopic hemostatic techniques on ovarian reserve after ovarian cystectomy. Ninety patients with unilateral ovarian cysts were recruited and randomly distributed into 2 groups. Laparoscopic stripping cystectomy was performed in all patients. Afterward, cystectomy hemostasis was achieved via hemostatic suture or bipolar electrocoagulation. Serum levels of anti-Müllerian hormone (AMH) were determined preoperatively and postoperatively at 1, 3, and 12 months, and patients were evaluated for residual ovarian volume, antral follicle count, and pregnancy. The statistical difference was determined between the 2 groups in terms of AMH levels at 3 months (hemostatic suture group = 3.17 ± 3.40 vs bipolar electrocoagulation group = 2.38 ± 2.57, P = .006) and 12 months (hemostatic suture group = 3.71 ± 3.09 vs bipolar electrocoagulation group = 2.78 ± 2.85, P = .005). In addition, in the hemostatic suture group, there was no statistically significant difference between preoperative and postoperative AMH levels ( P = .165) and between the postoperative antral follicle count ( P = .779) and the residual ovarian volume ( P = .248), whereas in the bipolar electrocoagulation group, postoperative AMH levels were lower than preoperative levels ( P = .028) and postoperative residual ovarian volumes at 3 and 12 months were lower than those at 1 month ( P = .001). Nonetheless, pregnancy rates were not significantly different ( P = .546). Bipolar electrocoagulation is more destructive compared with hemostatic suture. However, the ovarian reserve does not decrease further during the follow-up period.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Sahin
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Akdemir
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Ahmet Mete
authors.initials: AM
authors.lastname: Ergenoglu
authors.affiliation: 2 Department of Actuarial, Faculty of Science and Letter, Yasar University, Izmir, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Ozgurel
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Ahmet Ozgur
authors.initials: AO
authors.lastname: Yeniel
authors.affiliation: 3 Department of Physiology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Taskiran
authors.affiliation: 4 Department of Obstetrics and Gynecology, Faculty of Medicine, Acibadem University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Sendag
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010048:Ovarian Cysts / Q000097:blood / Q000601:surgery*; D065851:Ovarian Reserve / Q000502:physiology*; D010053:Ovary / Q000601:surgery*; D011184:Postoperative Period; D011247:Pregnancy; D018873:Pregnancy Rate; D013537:Sutures; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone
keywords: electrocautery; laparoscopic cystectomy; ovarian reserve; suture