Clinical effect of laparoscopic ovarian endometriosis cyst resection and the influence of different operative methods on follicle loss / 局解手术学杂志

ABSTRACT

Objective To analyze the clinical effect of laparoscopic ovarian endometriosis (EMs) cyst resection and the influence of different operative methods on follicle loss.Methods Selected 86 EMs patients with laparoscopic ovarian cyst resection in our hospital from January 2013 to January 2016 and randomly divided them into two groups.The control group adopted traditional blunt tearing method,while the observation group adopted sharp isolating method.The specimen thickness along with the number,thickness and grading of specimen with ovarian cortex at hilus orarii,middle part of ovarian fossa and ovarian fossa were observed.Meanwhile,the influence on ovarian function and follicle loss of the two operation methods were compared.Results The specimen thickness close to the hilus orarii was more than that of the ovarian fossa and the middle part of ovarian fossa (t =4.474,t =3.520,P ＜ 0.001).The thickness of specimen with ovarian cortex at ovarian fossa was significantly less than that of the middle part of ovarian fossa and the hilus orarii (t =1.705,t =4.428,P =0.046,P =0.000).The number of specimen ovarian cortex grading of 3 to 4 at hilus orarii was 20,which was significantly more than 2 at the ovarian fossa and 2 at the middle part(x2 =19.790,x2 =19.790,P ＜ 0.001).The specimen thickness and ovarian cortical thickness of the middle part of the observation group were less than those of the control group (t =3.897,t =2.166,P =0.000,P =0.017).The specimen number of ovarian cortex at the hilus orarii was significantly less than the control group(x2 =5.512,P =0.019),and the specimen thickness and the ovarian cortex thickness were obviously less than those of the control group (t =4.992,t =2.349,P =0.000,P =0.011).After operation,the differences between FSH,LH,and E2 levels in the two groups were not statistically significant(P ＞ 0.05),but the ovarian sinus follicle number and ovarian volume of the observation group were significantly more than those of the control group (t =7.181,t =10.921,P ＜ 0.00 001).The pregnancy rate of the observation group was 60.0％,which was significantly higher than 43.75 ％ of the control group (x2 =5.289,P =0.021).Conclusion The laparoscopic ovarian EMs cyst resection can cause the great loss of follicle in the progress of resecting cyst at hilus orarii,and advanced sharp separation can obviously reduce the loss of normal ovarian follicles and cause smaller influence on ovarian function.