以新型plasma energy 燒灼處理子宮內膜異位瘤可減少卵巢組織受損機率

以新型plasma energy 燒灼處理子宮內膜異位瘤可減少卵巢組織受損機率
1. 比較plasma energy 燒灼方式及傳統腹腔鏡剝除方式處理子宮內膜瘤發現plasma energy 燒灼方式明顯下降卵巢組織受損機率
2. 以新型plasma energy 燒灼處理後卵巢組織及原始濾泡均較傳統腹腔鏡剝除方式為高

Fertil Steril. 2011 Dec;96(6):1396-400. Epub 2011 Oct 22.

Ovarian endometrioma ablation using plasma energy versus cystectomy: a step toward better preservation of the ovarian parenchyma in women wishing to conceive.

Roman H, Auber M, Mokdad C, Martin C, Diguet A, Marpeau L, Bourdel N.

Source

Department of Gynecology and Obstetrics, Rouen University Hospital-Charles Nicolle, Rouen, France; Research Group 4308 Spermatogenesis and Gamete Quality, IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France.

Abstract

OBJECTIVE:

To use postoperative examination by three-dimensional (3D) ultrasound to compare loss of ovarian parenchyma after ovarian endometrioma ablation with the use of plasma energy versus cystectomy.

DESIGN:

Retrospective "before and after" comparative study.

SETTING:

University tertiary referral center.

PATIENT(S):

Thirty women with no previous history of ovarian surgery managed for unilateral ovarian endometrioma >30 mm in diameter.

INTERVENTION(S):

Endometrioma ablation using plasma energy and ovarian tissue-sparing cystectomy.

MAIN OUTCOME MEASURE(S):

3D ultrasound assessment of postoperative reduction in ovarian volume and antral follicle count (AFC).

RESULT(S):

Fifteen women with comparable baseline characteristics were managed by each technique. Those who underwent cystectomy showed a statistically significant reduction in ovarian volume and AFC when compared with women who underwent ablation using plasma energy. Multivariate analysis showed that the relationship between the decrease in ovarian volume and AFC and the use of cystectomy remained statistically significant after adjustment for age, previous pregnancy, and cyst diameter.

CONCLUSION(S):

When compared with plasma energy ablation, cystectomy is responsible for a statistically significant decrease in ovarian volume and a statistically significant reduction in AFC. This data should be taken into account in therapeutic decision-making concerning women attempting pregnancy, especially where there are other risk factors for postoperative ovarian failure.