Impact on ovarian reserve after laparoscopic ovarian cystectomy with reduced port number: a randomized controlled trial

Yoon, Bo Sung; Kim, You Shin; Seong, Seok Ju; Song, Taejong; Kim, Miseon; Paek, Jin Young

doi:10.1016/j.ejogrb.2014.02.025

Cited by 26 publications

(23 citation statements)

References 20 publications

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“…Our results support this hypothesis as AFC and AMH levels decrease significantly in comparison to MPL. A recently published, randomly controlled trial reported that laparoscopic ovarian cystectomy with a reduced number of ports does not affect the serial change of the ovarian reserve [27]. However, in this study only 19 cases of endometrioma were treated by SPAL in comparison to 15 patients by MPL.…”

Section: Discussionmentioning

confidence: 79%

Surgical technique of endometrioma excision impacts on the ovarian reserve. Single-port access laparoscopy versus multiport access laparoscopy: a case control study

Angioni

Pontis

Cela

et al. 2015

Gynecological Endocrinology

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Several recent studies report the detrimental effect of endometrioma excision on the ovarian reserve. Surgical technique and the excessive use of bipolar coagulation could be the key factors. Single-port access laparoscopy (SPAL) ovarian cystectomy has been reported as a comparable procedure to conventional laparoscopy in terms of operative outcomes. The aim of this study was to evaluate whether the single-port surgery affects the ovarian reserve whilst performing laparoscopic ovarian cystectomy for unilateral endometrioma. This was a prospective, case-control study of 99 women with unilateral endometrioma. Forty-nine women underwent single-port cystectomy and 50 women underwent multiport laparoscopic (MPL) conventional cystectomy. The primary outcome was the assessment of the ovarian reserve. We evaluated the serum anti-Mullerian hormone (AMH) levels before, 4-6 weeks and 3 months after surgery. At T2 we performed an ultrasound assessment of the antral follicular count (AFC). We have drawn attention to a statistically significant decrease of the mean AMH value and AFC in the SPAL group at the 4-6-week and 3-month follow-up compared to the conventional laparoscopy group. In conclusion, our results suggest that SPAL cystectomy should not be recommended to patients undergoing surgery for endometrioma excision who want to preserve their fertility.

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Section: Discussionmentioning

confidence: 79%

Surgical technique of endometrioma excision impacts on the ovarian reserve. Single-port access laparoscopy versus multiport access laparoscopy: a case control study

Angioni

Pontis

Cela

et al. 2015

Gynecological Endocrinology

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“…A prospective longitudinal study about the short‐term measurement of serum AMH levels after ovarian surgery demonstrated that the median AMH level was 2.23 ng/ml [95% confidence interval (CI) 1.35–3.41 ng/ml] before surgery, but decreased to 0.67 ng/ml (95% CI 1.35–3.41 ng/ml) at 1 week post‐surgery, and then increased to 1.14 ng/ml (95% CI 0.79–2.36 ng/ml) at 1 month post‐surgery, and 1.50 ng/ml (95% CI 0.58–3.26 ng/ml) at 3 months post‐surgery, indicating that the ovarian reserve was reduced after ovarian surgery but was restored at 3 months post‐surgery . This result was in line with a study we previously reported about ovarian surgeries using different laparoscopic port numbers . Another prospective study about long‐term measurement for serum AMH levels after ovarian surgery demonstrated that there was no change in AMH level at 3, 6 and 12 months post‐surgery .…”

Section: Discussionmentioning

confidence: 99%

Impact of opportunistic salpingectomy on anti‐Müllerian hormone in patients undergoing laparoscopic hysterectomy: a multicentre randomised controlled trial

Song

et al. 2016

BJOG

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“…There have been six comparative randomized studies of the postoperative benefits regarding adnexal surgery (e.g. adnexectomy, ovarian cystectomy) by SPL vs CL [ 16 – 21 ]. We performed a meta-analysis including these six studies that did not find significant differences in terms of the benefits between SPL and CL, and that hence does not allow SPL to be recommended at present for adnexal surgery [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of laparoscopy by single-port endoscopic access in benign adnexal surgery: study protocol for a randomized controlled trial

Schmitt

Crochet

Baumstark

et al. 2018

Trials

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BackgroundLaparoscopic surgery has become the preferred surgical approach due to a reduction in postoperative pain, better recovery, shorter hospitalization, and improved esthetic outcomes. Laparoscopic surgery with single-port laparoscopy (SPL) is a laparoscopic surgery technique that is based on making a single parietal incision using a single trocar specifically designed to allow introduction of several instruments. The level of evidence regarding the advantages of SPL in terms of postoperative pain has remained low despite several randomized studies. Adult patients exhibiting a surgical indication for an a priori benign ovarian pathology or for prophylactic purposes that can be performed by laparoscopy will be randomized to receive conventional laparoscopy (CL) or SPL. The aim of our study is to evaluate whether SPL offers advantages over CL in benign adnexal surgery.MethodsThe patients will be evaluated preoperatively to confirm their eligibility. The perioperative data up to 24 h after the intervention, as well as the postoperative data at day 7 and at one month from the intervention will be collected. The primary outcome for the study will be the postoperative pain at 24 h ± 2 h after the intervention. The pain will be assessed by a numeric rating scale of 0–10.Other outcomes will also be assessed, such as pain at other times, the consumption of analgesics, the operative time, perioperative bleeding, the number of additional trocars in the two groups, the incidence of laparoconversion, the esthetic criteria of the scar at one month, the incidence of complications, and the quality of life at one month.DiscussionIf our hypothesis is confirmed, this study will provide evidence that the use of SPL can decrease postoperative pain in adnexal surgery. The standard surgical treatment of this condition would thus be modified.Trial registrationClinicalTrials.gov, NCT02739724. Registered on 12 April 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2429-y) contains supplementary material, which is available to authorized users.

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Impact on ovarian reserve after laparoscopic ovarian cystectomy with reduced port number: a randomized controlled trial

Cited by 26 publications

References 20 publications

Surgical technique of endometrioma excision impacts on the ovarian reserve. Single-port access laparoscopy versus multiport access laparoscopy: a case control study

Surgical technique of endometrioma excision impacts on the ovarian reserve. Single-port access laparoscopy versus multiport access laparoscopy: a case control study

Impact of opportunistic salpingectomy on anti‐Müllerian hormone in patients undergoing laparoscopic hysterectomy: a multicentre randomised controlled trial

Effect of laparoscopy by single-port endoscopic access in benign adnexal surgery: study protocol for a randomized controlled trial

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