Comparison of hemostatic sealants on ovarian reserve during laparoscopic ovarian cystectomy.

OBJECTIVE: To determine whether different methods of hemostasis and pathologic subtypes would lead to significant differences regarding ovarian reserve after laparoscopic ovarian cystectomy.

STUDY DESIGN: Data were prospectively collected from 129 patients who underwent laparoscopic ovarian cystectomy with either a hemostatic sealant (FloSeal or TachoSil) or bipolar coagulation to achieve hemostasis. Serum anti-Müllerian hormone (AMH) levels as measured by enzyme immunoassay. Measurements were made preoperatively and at 3 months postsurgery in each group [bipolar coagulator group (n=43), FloSeal group (n=46), and TachoSil group (n=40)].

RESULTS: Age, BMI, parity, sociodemographic variables, and preoperative AMH levels were similar between the three groups of patients. At 3 months post-surgery, the AMH decline rate was significantly greater in the bipolar coagulation group compared with the two hemostatic sealant groups (41.2% [IQR, 16.7-52.4] vs. 15.4% [IQR, 5.2-41.9], respectively; P=0.003). However, the AMH decline rates of the two hemostatic sealant groups (FloSeal and TachoSil) were not significantly different (15.4% [IQR, 7.8-44.6] vs. 15.9% [IQR, 0.7-41.1], P=0.962). Also, subgroup analysis according to ovarian cyst type revealed no significant differences in the rate of serum AMH decline regardless of the hemostatic method (bipolar group, P=0.30; FloSeal group, P=0.47, and TachoSil group, P=0.79).

CONCLUSION: The two hemostatic sealants (FloSeal and Tachosil) did not exhibit any significant differences regarding the preservation of ovarian reserve regardless of ovarian cyst type.