A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy

Abstract The preservation of ovarian reserve during laparoendoscopic single-site (LESS) ovarian cystectomy is crucial for reproductive-age women. This study was a single-blinded, single-center, and randomized controlled trial to evaluate the effect of hemostatic agents on the preservation of ovarian...

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Autores principales:	Soo Jin Park, Aeran Seol, Nara Lee, Seungmee Lee, Hee Seung Kim, PRAHA Study Group
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/43d27f1f502045169965930f6e9279cb
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spelling	oai:doaj.org-article:43d27f1f502045169965930f6e9279cb2021-12-02T15:27:06ZA randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy10.1038/s41598-021-87965-72045-2322https://doaj.org/article/43d27f1f502045169965930f6e9279cb2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87965-7https://doaj.org/toc/2045-2322Abstract The preservation of ovarian reserve during laparoendoscopic single-site (LESS) ovarian cystectomy is crucial for reproductive-age women. This study was a single-blinded, single-center, and randomized controlled trial to evaluate the effect of hemostatic agents on the preservation of ovarian reserve and hemostasis during LESS ovarian cystectomy. Patients with unilateral ovarian cyst were randomized to the hemostatic agent and coagulation groups according to the hemostasis method. Afterwards, the patients underwent LESS ovarian cystectomy, and hemostasis was performed after ovarian cyst excision according to the assigned hemostasis method. If hemostasis was not completed within 10 min. After discharge, the patients were followed until 3 months after surgery. We compared the hemoglobin, anti-Müllerian hormone (AMH) levels, and ovarian volumes before surgery, and 2 days, 1 week, and 3 months after surgery (3 M-POST), and the decline ratio between the two groups. The decline ratio of serum AMH levels was greater at 3 M-POST in the coagulation than in the hemostatic agent group (median intention-to-treat [ITT], − 36.7 vs. − 13.3%; per-protocol [PP], − 36.8 vs. − 13.3%; P < 0.05). Notably, the difference of the decline ratio of serum AMH levels was only shown in endometriosis patients (median; ITT, − 50.7 vs. − 14.4%; PP, − 50.7% vs. − 14.4%; P < 0.05), while there was no difference in non-endometriosis patients. In conclusion, Hemostatic agents may be non-inferior to bipolar coagulation for preserving ovarian reserve and hemostasis during LESS ovarian cystectomy, in particular, for endometriosis patients. (Trial registry: ClinicalTrials.gov Identifier NCT03374397).Soo Jin ParkAeran SeolNara LeeSeungmee LeeHee Seung KimPRAHA Study GroupNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Soo Jin Park Aeran Seol Nara Lee Seungmee Lee Hee Seung Kim PRAHA Study Group A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
description	Abstract The preservation of ovarian reserve during laparoendoscopic single-site (LESS) ovarian cystectomy is crucial for reproductive-age women. This study was a single-blinded, single-center, and randomized controlled trial to evaluate the effect of hemostatic agents on the preservation of ovarian reserve and hemostasis during LESS ovarian cystectomy. Patients with unilateral ovarian cyst were randomized to the hemostatic agent and coagulation groups according to the hemostasis method. Afterwards, the patients underwent LESS ovarian cystectomy, and hemostasis was performed after ovarian cyst excision according to the assigned hemostasis method. If hemostasis was not completed within 10 min. After discharge, the patients were followed until 3 months after surgery. We compared the hemoglobin, anti-Müllerian hormone (AMH) levels, and ovarian volumes before surgery, and 2 days, 1 week, and 3 months after surgery (3 M-POST), and the decline ratio between the two groups. The decline ratio of serum AMH levels was greater at 3 M-POST in the coagulation than in the hemostatic agent group (median intention-to-treat [ITT], − 36.7 vs. − 13.3%; per-protocol [PP], − 36.8 vs. − 13.3%; P < 0.05). Notably, the difference of the decline ratio of serum AMH levels was only shown in endometriosis patients (median; ITT, − 50.7 vs. − 14.4%; PP, − 50.7% vs. − 14.4%; P < 0.05), while there was no difference in non-endometriosis patients. In conclusion, Hemostatic agents may be non-inferior to bipolar coagulation for preserving ovarian reserve and hemostasis during LESS ovarian cystectomy, in particular, for endometriosis patients. (Trial registry: ClinicalTrials.gov Identifier NCT03374397).
format	article
author	Soo Jin Park Aeran Seol Nara Lee Seungmee Lee Hee Seung Kim PRAHA Study Group
author_facet	Soo Jin Park Aeran Seol Nara Lee Seungmee Lee Hee Seung Kim PRAHA Study Group
author_sort	Soo Jin Park
title	A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
title_short	A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
title_full	A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
title_fullStr	A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
title_full_unstemmed	A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
title_sort	randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/43d27f1f502045169965930f6e9279cb
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A randomized controlled trial of ovarian reserve preservation and hemostasis during ovarian cystectomy

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