Epinephrine minimizes the use of bipolar coagulation and preserves ovarian reserve in laparoscopic ovarian cystectomy: a randomized controlled trial

Eun Young Park, Kyu Hee Hwang, Ji Hee Kim, San Hui Lee, Kyu Sang Park, Seong Jin Choi, Seung Kuy Cha

Research output: Contribution to journalArticlepeer-review

Abstract

We propose a novel method, the epinephrine compression method (Epi-pledget), as a hemostasis method for ovarian cystectomy. A total of 179 patients undergoing laparoscopic ovarian cystectomy with stripping were randomly allocated into three groups: the bipolar coagulation group, the Epi-pledget group, and the coagulation after Epi-pledget (Epi & Coagulation) group. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) by ultrasonography were measured to determine the preservation of ovarian function. To evaluate the postoperative ovarian cellular proliferative activity and tissue damage in a mouse model, we operated on the ovaries of mice with an artificial incision injury and applied two hemostatic methods: coagulation and Epi-pledget. Eight weeks after surgery, the AMH rate significantly decreased in the bipolar coagulation group compared with the Epi-pledget group. The AFC decline rate was also significantly greater in the coagulation group than the Epi-pledget group. Specifically, patients with endometrioma had a significantly greater decline of serum AMH in the coagulation group than the Epi-pledget group. In a histopathological analysis in mice, the Epi-pledget group showed ameliorated fibrotic changes and necrotic findings in the injured lesion compared with the bipolar coagulation group. The Epi-pledget method for ovarian stripping has an additional benefit of maximizing the preservation of the ovarian reserve, especially for the endometriotic ovarian cyst type.

Original languageEnglish
Article number20911
JournalScientific reports
Volume10
Issue number1
DOIs
Publication statusPublished - 2020 Dec

Bibliographical note

Funding Information:
This study was supported by the Medical Research Center Program (2017R1A5A2015369) through the National Research Foundation of Korea and funded by the Ministry of Health & Welfare, Republic of Korea (HI18C2196).

Publisher Copyright:
© 2020, The Author(s).

All Science Journal Classification (ASJC) codes

  • General

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