Effect of Hemostatic Method on Ovarian Reserve Following Laparoscopic Endometrioma Excision; Comparison of Suture, Hemostatic Sealant, and Bipolar Dessication. A Systematic Review and Meta-Analysis

Ata, Barış; Türkgeldi, Engin; Seyhan, Ayşe; Urman, Bülent

doi:10.1016/j.jmig.2014.12.168

Cited by 81 publications

(79 citation statements)

References 47 publications

(60 reference statements)

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“…In the other two studies, the difference between the hemostasis methods was not significant. These findings are in agreement with previous comparative studies, an RCT, and two meta‐analyses, pointing to a detrimental effect of bipolar hemostasis on the ovarian reserve, as indicated by a greater decrease of AMH in the bipolar hemostasis group.…”

Section: Discussionsupporting

confidence: 92%

“…Given that RCTs are considered to provide the best level of evidence, the exclusion of other types of study could have increased the statistical accuracy of the present meta‐analysis. Additionally, although the total number of patients included in the two meta‐analyses was similar (n=210 in the present study vs n=213 in the study by Ata et al …”

Section: Discussionmentioning

confidence: 49%

“…demonstrated in a systematic review and meta‐analysis that bipolar electrocoagulation has a more negative impact on the ovarian reserve than do alternative hemostasis methods: the mean reduction in serum AMH at 3 months after surgery was 7.0% (95% confidence interval [CI] −3.0% to −0.9%, P= 0.02) smaller with alternative methods than with bipolar electrocoagulation. The present study differs from the study by Ata et al . because the present analysis included RCTs only.…”

Section: Discussionmentioning

confidence: 61%

“…The present finding that bipolar hemostasis is more detrimental to ovarian reserve than other types of hemostasis is supported by previous results. Ata et al . demonstrated in a systematic review and meta‐analysis that bipolar electrocoagulation has a more negative impact on the ovarian reserve than do alternative hemostasis methods: the mean reduction in serum AMH at 3 months after surgery was 7.0% (95% confidence interval [CI] −3.0% to −0.9%, P= 0.02) smaller with alternative methods than with bipolar electrocoagulation.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review and meta‐analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve

Deckers

Ribeiro

Simões

et al. 2017

Intl J Gynecology & Obste

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and meta‐analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve

Deckers

Ribeiro

Simões

et al. 2017

Intl J Gynecology & Obste

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“…Most of these studies compared suturing and bipolar coagulation. Excessive bipolar coagulation causes damage to the ovarian cortex, resulting in a postoperative decline in ovarian reserve [36]. On the other hand, Shao et al found a postoperative decline in serum AMH levels in the suturing group after cystectomy [37].…”

Section: Discussionmentioning

confidence: 99%

Involvement of mesosalpinx in endometrioma is a possible risk factor for decrease of ovarian reserve after cystectomy: a retrospective cohort study

Saito

Iwase

Nakamura

et al. 2016

Reprod Biol Endocrinol

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BackgroundSerum anti-Müllerian hormone (AMH) concentration has been used to assess ovarian reserve in patients with endometriosis, especially when endometrioma surgery is involved. Previously, we reported that decreased serum AMH levels after cystectomy for endometriomas can recover to preoperative levels in some cases. In this present study, we assessed the sequential changes in serum AMH levels before and after cystectomy in terms of the state of the mesosalpinx prior to surgery.MethodsThe retrospective cohort study recruited 53 patients from a series of prospective studies conducted from 2009 to 2015. All patients underwent laparoscopic cystectomy for endometriomas. If either mesosalpinx was involved in the endometrioma or adnexal adhesion before cystectomy, the case was defined as ‘involved mesosalpinx’ (n = 14). If both mesosalpinx remained anatomically correct, the case was classified as ‘intact mesosalpinx’ (n = 39). Blood samples were obtained from the patients 2 weeks before surgery, and at 1 month and 1 year after surgery to assess serum AMH levels.ResultsThe serum AMH levels (the involved group vs. the intact group) were 1.92 vs. 0.98 (P = 0.552) preoperatively, 0.59 vs. 1.99 (P = 0.049) at 1 month postoperatively, and 0.48 vs. 2.37 ng/mL (P = 0.007) at 1 year postoperatively. The involved mesosalpinx group showed a further decrease in serum AMH levels at 1 year postoperatively, while serum AMH levels in the intact mesosalpinx group tended to recover.ConclusionThese results suggest that pre-existing mesosalpinx disturbance, in combination with adhesiolysis, may be involved in the medium- and long-term decrease in ovarian reserve after endometrioma surgery. A disturbance in ovarian blood supply via the mesosalpinx may underlie this.Trial registrationUMIN-CTR UMIN000019369. Retrospectively registered October 15, 2015.

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Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: A randomized controlled trial

Araujo

Maia

Baracat³

et al. 2021

Intl J Gynecology & Obste

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Objective To compare the effect of hemostatic techniques (bipolar energy versus hemostatic sealants versus suture) on the ovarian reserve of patients submitted to laparoscopic cystectomy for the surgical excision of unilateral endometrioma. Methods A randomized controlled trial conducted in a teaching hospital included 84 patients with unilateral endometrioma. The patients underwent laparoscopic stripping for excision of the unilateral endometrioma between March 2018 and February 2020. Three different hemostatic techniques—bipolar energy (Group 1), hemostatic sealants (Group 2), and suture (Group 3)—were compared. Anti‐Müllerian hormone (AMH) levels were measured before, and 1 and 6 months after surgery to determine changes in ovarian function. Results Following surgery, AMH levels decreased in all the groups; however, this decrease was not statistically significant. Comparison between groups showed no statistically significant differences in AMH levels between the three hemostatic techniques used. Six months after surgery, median AMH levels were: 1.65 ng/mL (interquartile range [IQR] 0.62–2.08 ng/mL) in Group 1, 1.87 ng/mL (IQR 1.27–2.97 ng/mL) in Group 2, and 1.53 ng/mL (IQR 1.18–2.44 ng/mL) in Group 3. Conclusion The present study suggests that there is no difference between the different hemostatic techniques used in laparoscopic cystectomy for the treatment of unilateral endometriomas. Registered at ClinicalTrials.gov: NCT03430609. https://clinicaltrials.gov/ct2/show/NCT03430609

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Effect of Hemostatic Method on Ovarian Reserve Following Laparoscopic Endometrioma Excision; Comparison of Suture, Hemostatic Sealant, and Bipolar Dessication. A Systematic Review and Meta-Analysis

Cited by 81 publications

References 47 publications

Systematic review and meta‐analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve

Systematic review and meta‐analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve

Involvement of mesosalpinx in endometrioma is a possible risk factor for decrease of ovarian reserve after cystectomy: a retrospective cohort study

Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: A randomized controlled trial

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