腹腔镜下卵巢囊肿剔除术中不同的止血方式对卵巢储备功能的影响

Effects of various hemostasis approaches on ovarian reserve after laparoscopic cystectomy in patients with ovarian cyst

目的探讨腹腔镜下卵巢囊肿剔除术中不同止血方式对卵巢储备功能的影响。方法根据腹腔镜下卵巢囊肿剔除术中止血方式不同,随机分为3组:电凝组34例、超声刀组34例和缝合组34例。采用化学发光法对3组患者术前、术后1个月和3个月检测血清雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH),并采用阴道彩色多普勒超声检测术后3个月卵巢情况。结果 3组术前E2、FSH和LH水平比较差异无统计学意义(P>0.05),电凝组和超声刀组术后1个月、3个月FSH、LH与术前比较升高(P<0.05),缝合组没有变化(P>0.05)。3组术后3个月手术侧窦卵泡数较未手术侧均减少(P<0.05)。结论腹腔镜下卵巢囊肿剔除术中缝合止血对卵巢储备功能无影响,术中应尽量保留正常卵巢组织。

Objective To investigate the effects of various hemostasis approaches on ovarian reserve after laparoscopic cystectomy in patients with ovarian cyst. Methods We randomly assigned patients with ovarian cyst, based on the approaches for hemostasis employed during the surgery, to electric coagulation group （n=34）, ultrasound knife group （n=34） and suture group （n=34）, respectively. Serum estradiol （E2）, follicular stimulating hormone （FSH） and luteinizing hormone （LH） were examined prior to the operation and at months 1 and 3 post-operatively, via chemiluminescence assay. The ovarian reserve was tested by using transvaginal color Doppler uhrasonography at month 3 post-operatively. Results There was no significant difference in serum FSH, LH and E2 among the three groups （P〉 0.05） prior to surgery. As compared with pre-operative levels, both electric coagulation group and ultrasound knife group, but not suture group （P〉O.05）, resulted in increased FSH and LH at months 1 and 3 post-operatively （both P〈 0.05）. All groups showed reduced antral follicle count in the operated side at month 3 post-operatively （all P〈0.05）. Conclusion Suture hemostasis during laparoscopic cystectomy does not influence ovarian reserve in patients with ovarian cyst inasmuch that normal ovarian tissues are retained during the surgery.