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

Moszyński, Rafał; Burchardt, Bartosz; Sajdak, Stefan; Moszynska, Marta; Englert-Golon, Monika; Olbromski, Piotr

doi:10.3390/medicina59010014

Cited by 6 publications

(3 citation statements)

References 45 publications

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“…Bipolar coagulation of the ovarian bleeding site is another effective method of hemostasis but can also potentially harm the surrounding ovarian tissue. Therefore, to avoid damage to healthy ovarian tissue, hemostasis using various topical hemostatic agents has been suggested as a method of choice whenever possible [ 53 , 54 , 55 ]. Several topical hemostatic agents that exert their effect in a variety of ways are currently available in a range of preparations.…”

Section: Discussionmentioning

confidence: 99%

“…Relatively recent agents are those based on polysaccharides, albumin, glutaraldehyde, and inorganic agents. Studies have shown that using hemostatic sealants has a positive effect on the ovarian reserve compared to the use of bipolar coagulation and ovarian suturing, as these patients had better levels of anti-Mullerian hormone and antral follicular count postoperatively [ 53 , 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

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Severe Hemoperitoneum due to Ovarian Bleeding after Transvaginal Oocyte Retrieval with Surgical Management: A Retrospective Analysis and Comprehensive Review of the Literature

et al. 2023

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Background and Objectives: Severe hemoperitoneum of ovarian bleeding origin is a rare but potentially life-threatening complication of transvaginal oocyte retrieval (TVOR) procedure. The study aimed to present a case series of surgically managed patients from our clinic with hemoperitoneum caused by ovarian bleeding after TVOR, as well as to perform a comprehensive literature review in order to summarize and analyze all published cases with this condition and their management. Materials and Methods: The data of 2939 patients, who underwent TVOR procedures for IVF/ICSI (in vitro fertilization, intracytoplasmic sperm injection) in our clinic between 2010 and 2021 were reviewed. Moreover, a systemic literature search was performed. Main outcome measures from the pooled analysis were incidence and risk factors, type of surgery, intraoperative finding and intervention leading to hemostasis. Results: In our Clinic 4 (0.136%), cases of hemoperitoneum due to ovarian bleeding were surgically managed. Moreover, 39 cases from 18 studies reported in the literature were identified. No risk factors besides lean women with PCOS were identified. In the pooled analysis, the bleeding symptoms appeared in 58.1% of patients within eight hours after TVOR and cumulatively in 81.4% cases during the 24 hours after TVOR. The average time from TVOR to surgery was 27.19 ± 53.25 hours. Hemostasis was mostly established using electrocoagulation, although few cases of ovariectomy were also reported. Embryo transfer at 60% of cases was postponed and embryos cryopreserved. Conclusions: Severe hemoperitoneum due to ovarian bleeding after TVOR is a rare event that should be treated by techniques of minimally invasive surgery whenever possible. Protocols should be developed to enable optimal management strategies for infertility patients. Embryos obtained should be cryopreserved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Severe Hemoperitoneum due to Ovarian Bleeding after Transvaginal Oocyte Retrieval with Surgical Management: A Retrospective Analysis and Comprehensive Review of the Literature

et al. 2023

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“…However, this study did not contain a control group. Moszynski et al ( 2022 ) described the use of potato starch as a haemostatic agent compared to bipolar coagulation in laparoscopic ovarian surgery and showed that the use of modified potato starch might reduce the loss of ovarian reserve due to reduced need of coagulation. Ziegler and De Wilde ( 2022 ) also demonstrated a reduced adhesiogenesis after laparoscopic adhesiolysis using 4DF in a retrospective analysis.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Peritoneal Granulomatous Inflammation After the Application of Potato Starch-Based Anti-Adhesive Agent in Laparoscopic Endometriosis Surgery

Krentel,

Naem,

Tannapfel

et al. 2023

Facts Views Vis ObGyn

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Background: Endometriosis is a chronic inflammatory oestrogen-dependent disease. It is characterised by elevated inflammatory markers in the peritoneal milieu with subsequent adhesiogenesis. Nowadays, excisional, and ablative surgeries are considered the main treatment of endometriosis, and adhesiolysis is being performed almost routinely during these procedures. Postoperative adhesion formation is a significant concern for many surgeons, especially as endometriosis patients are assumed to be predisposed to adhesiogenesis. In order to minimise adhesiogenesis after endometriosis surgery, the usage of different barrier methods have been discussed in the literature. Recent studies aim to investigate the effect of potato starch preparations on adhesion formation in endometriosis patients. Objectives: We aim to describe the findings of a second-look laparoscopy on patients who received a starch-based anti-adhesive agent. Materials and Methods: We present a retrospective case series that included the medical, surgical, and histopathologic data of three patients. Main Outcome Measures: Intraperitoneal adhesion formation and peritoneal inflammation. Results: All three patients had de-novo adhesions during the second-look laparoscopy. Pathological examination revealed noncaseating granulomatosis of the peritoneum in all patients. Conclusion: The use of potato starch-based agents as a peritoneal adhesion prophylaxis in laparoscopic endometriosis surgery could lead to granulomatous peritoneal inflammation. Correct application by avoiding powder remnants through complete rinsing and transformation to gel seems to be an important factor to avoid this adverse effect. What is new? We aim to highlight that potato starch-based anti-adhesive agents similar to the one used in this study could be a cause of adhesiogenesis and peritoneal inflammation.

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Hemostatic agents can be considered as an at least non-inferior approach for preservation of ovarian reserve after cystectomy for endometriomas

Iavazzo,

Kokkali,

Fotiou

2023

Arch Gynecol Obstet

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

Cited by 6 publications

References 45 publications

Severe Hemoperitoneum due to Ovarian Bleeding after Transvaginal Oocyte Retrieval with Surgical Management: A Retrospective Analysis and Comprehensive Review of the Literature

Severe Hemoperitoneum due to Ovarian Bleeding after Transvaginal Oocyte Retrieval with Surgical Management: A Retrospective Analysis and Comprehensive Review of the Literature

Postoperative Peritoneal Granulomatous Inflammation After the Application of Potato Starch-Based Anti-Adhesive Agent in Laparoscopic Endometriosis Surgery

Hemostatic agents can be considered as an at least non-inferior approach for preservation of ovarian reserve after cystectomy for endometriomas

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