Using a Modified Polysaccharide as a Hemostatic Agent Results in Less Reduction of the Ovarian Reserve after Laparoscopic Surgery of Ovarian Tumors-Prospective Study

Medicina (Kaunas). 2022 Dec 21;59(1):14. doi: 10.3390/medicina59010014.

Abstract

Background and Objectives: The study investigated whether the method of achieving hemostasis affects the ovarian reserve in patients undergoing laparoscopic surgery due to ovarian tumors or cysts. Materials and Methods: Patients with unilateral tumors or ovarian cysts, who qualified for laparoscopic tumor enucleation, were randomly selected to receive modified polysaccharides or bipolar coagulation. Ovarian reserve was analyzed by anti-Mullerian hormone (AMH) level. Results: The study included 38 patients: 19 patients in the modified polysaccharide group and 19 in the bipolar coagulation group. Patients after bipolar coagulation treatment had statistically significantly lower AMH 6 months after surgery compared to the group treated with modified starch. The levels of AMH in the study and control groups were 3.96 +/- 2.12 vs. 2.51 +/- 1.39 ng/mL, respectively; p = 0.018. A statistically significant decrease in AMH was also demonstrated in the bipolar coagulation group as compared to the preoperative assessment (p = 0.049). There was no statistically significant decrease in AMH in the group of patients treated with the modified starch. Conclusions: Using a modified polysaccharide during laparoscopic cystectomy is effective and has a positive effect on the ovarian reserve compared to the use of bipolar coagulation. Both the AMH level 6 months after surgery and the percentage decrease in AMH were more favorable in the group of patients treated with modified starch.

Keywords: cystectomy; hemostasis; laparoscopy; ovarian function; starch.

MeSH terms

  • Anti-Mullerian Hormone
  • Endometriosis* / surgery
  • Female
  • Hemostatics* / therapeutic use
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Ovarian Neoplasms* / surgery
  • Ovarian Reserve*
  • Polysaccharides
  • Prospective Studies
  • Starch

Substances

  • Hemostatics
  • Polysaccharides
  • Anti-Mullerian Hormone
  • Starch

Grants and funding

This research received no external funding.