Systematic review and meta‐analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve

Paula Deckers, Sérgio Conti Ribeiro, Ricardo Dos Santos Simões, Ricardo Santos Simões, Camila Barião da Fonseca Miyahara, Edmund Chada Baracat
International Journal of Gynecology & Obstetrics · 2017 · vol. 140(1) , pp. 11–17 · doi:10.1002/ijgo.12338 · PMID:28980317 · W2763791788
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This meta-analysis found that bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping significantly reduced postoperative anti-Müllerian hormone levels compared to non-thermal hemostasis methods.

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Abstract

BACKGROUND: Laparoscopic stripping is the gold-standard treatment for ovarian endometriosis. The choice of hemostasis method might affect ovarian reserve. OBJECTIVES: To determine whether bipolar electrocoagulation is more detrimental to ovarian reserve than non-thermal hemostasis methods. SEARCH STRATEGY: Entry terms associated with the MeSH terms "endometrioma," "laparoscopy," and "ovarian reserve" were used to search databases for articles published up to April 3, 2017, in English, Spanish, Portuguese, French, and Italian. SELECTION CRITERIA: Randomized controlled trials comparing the 3-month postoperative serum anti-Müllerian hormone (AMH) level in premenopausal women undergoing laparoscopic stripping with bipolar hemostasis or non-thermal hemostasis methods were selected. DATA COLLECTION AND ANALYSIS: Data were extracted by two independent reviewers and a meta-analysis was performed. MAIN RESULTS: Three studies met the inclusion criteria; overall, 105 patients underwent surgery with bipolar electrocoagulation and 105 patients underwent surgery with an alternative hemostasis method. The AMH level 3 months after surgery was decreased in the bipolar electrocoagulation group (mean difference -0.79 ng/mL, 95% confidence interval -1.19 to -0.39). CONCLUSIONS: Bipolar electrocoagulation negatively impacts ovarian reserve and should be avoided, especially for patients with reproductive goals.

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Condition tags

mesh:D004715endometriosisendometrioma

MeSH descriptors

Electrocoagulation Endometriosis Hemostasis, Surgical Laparoscopy Ovarian Reserve Adult Anti-Mullerian Hormone Anti-Mullerian Hormone Electrocoagulation Electrocoagulation Endometriosis Female Hemostasis, Surgical Hemostasis, Surgical Humans Laparoscopy Laparoscopy Ovary Ovary Postoperative Period

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (37)

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