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| Influence of laparoscopic surgery combined with GnRHa on ovarian function of patients with ovarian chocolate cysts |
| Nanjing Dachang Hospital (Jiangbei campus of Zhongda Hospital Affiliated to Southeast University) , Jiangsu Province, 210000 |
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Abstract To investigate the effect of laparoscopic surgery combined with gonadotropinreleasing hormone agonists (GnRHa) for treating patients with ovarian chocolate cysts, and to explore its influence on ovarian function of patients. Methods: 92 patients with ovarian chocolate cysts were randomly divided into observation group and control group (46 cases in each group).The patients in both groups underwent laparoscopic chocolate cystectomy, and patients in observation group received GnRHa injection 3 times after surgery. The rates of symptom relief, postoperative recurrence, and pregnancy were compared between the two groups. Serum levels of sex hormones (LH, FSH, E2) and anti-Mullerian hormone (AMH) were determined before and at 3 and 6 months after surgery. The peak systolic peak (PSV) of ovarian interstitial arterial blood flow, antral follicle number (AFC), ovary volume (OV) were measure by ultrasonography. Results: There was no significant difference in total effective rate between the observation group and the control group (97.8% VS 93.5%, P>0.05). At 6 months after surgery, there were no significant different in the time of menstrual period, VAS scores, bone mineral density (BMD), modified Kupperman score and the incidence of perimenopausal syndrome between the two groups (P>0.05). At 3 months after surgery, the level FSH of patients in observation group was significant higher than that of patients in control group, but levels of LH, E2, and AMH were significant lower (P<0.05). 6 months after operation, there were no significant differences in serum FSH, LH, E2, and AMH, and in PSV, AFC, OV between the two groups (P>0.05). The recurrence rate of patients in observation group was 6.8%, which was significant lower than that (22.0%) of patients in control group (P<0.05). The postoperative pregnancy rate of patients in observation group was 70.6%, which was significant higher than that (30.0%) of patients in control group (P<0.05). Conclusion: Laparoscopic cystectomy combined with GnRHa has no any influence on efficacy of cystectomy and ovarian function of patients with ovarian chocolate cysts, but it can reduce postoperative recurrence rate and increase the rate of postoperative pregnancy.
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