Ovarian Cysts Clinical Trial
Official title:
Additional Benefit of Hemostatic Sealant in Preserving Ovarian Reserve During Laparoscopic Ovarian Cystectomy: a Randomized Controlled Trial
Laparoscopy has become the gold standard for the surgical treatment of benign ovarian cysts
and is usually performed by stripping the ovarian cyst wall, followed by bleeding control of
the ovarian wound ground using bipolar coagulation. However, the hemostasis with bipolar
coagulation could result in the damage of ovarian reserve and decrease the response of the
ovaries to hormonal stimulation for assisted reproductive technologies. The possible
mechanism may contribute to thermal destruction of ovarian follicles by excessive use of
bipolar coagulation for hemostasis purposes.
To avoid additional ovarian tissue damage by conventional bipolar coagulation being
potentially important ovarian reproductive function, hemostasis using various topical
hemostatic agents has introduced to control post-cystectomy ovarian wound bleeding. Among
them, FloSeal (Baxter Healthcare Corporation, Deerfield, IL, USA) is a hemostatic matrix
sealant composed of a gelatin-based matrix and thrombin solution. On coming into contact
with blood after application at a bleeding site, the gelatin particles swell and tamponade
bleeding. The bulk of the gelatin matrix-thrombin composite has the effect of slowing blood
flow and providing exposure to a high thrombin concentration, thus hastening clot formation.
Therefore, it may more suitable for use in post-cystectomy ovarian wound bleeding, where
there is superficially pervasive focus of bleeding.
Ovarian reserve is defined as the functional potential of the ovary, which reflects the
number and quality of antral follicles left in the ovary, and is correlated with the
response to ovarian stimulation using exogenous gonadotropin. Serum anti-Müllerian hormone
(AMH) has been accepted as the most reliable and easily measurable marker for postoperative
assessment of ovarian reserve.
The investigators conducted a multicenter, large-scale, randomized controlled trial to
investigate whether hemostasis by Floseal was superior to that by bipolar coagulation in
preserving ovarian reserve by assessing serial AMH levels in patients undergoing
laparoscopic ovarian cystectomy for benign ovarian cysts.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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