Evaluation of Ovarian Reserve and Recurrence Rate After DWLS Diode Laser Ovarian Endometrioma Vaporization (OMAlaser): A Prospective, Single-Arm, Multicenter, Clinical Trial

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2025-03-01 DOI:10.1016/j.jmig.2024.10.021

Maurizio Nicola D'Alterio MD , Luigi Nappi MD, PhD , Salvatore Giovanni Vitale MD, PhD , Mirian Agus PhD , Daniela Fanni MD, PhD , Mario Malzoni MD , Francesca Falcone MD , Felice Sorrentino MD, PhD , Maria Gabriella D'Agate MD , Giuseppe Scibilia MD , Liliana Mereu MD, PhD , Paolo Scollo MD, PhD , Stefano Angioni MD, PhD

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引用次数: 0

Abstract

Study Objective

To evaluate the effectiveness of the Dual Wavelength Laser System (DWLS) diode laser on the treatment of ovarian endometrioma (OMA), with ablation and vaporization of the cystic capsule without performing the stripping technique, in terms of ovarian reserve and recurrence rate.

Design

Prospective, single-arm, multicenter, clinical trial.

Setting

Multicenter University Hospital.

Patients

Seventy patients with symptomatic OMA.

Interventions

Patients underwent surgery for primary unilateral or bilateral symptomatic OMA treated with DWLS diode laser vaporization. Following surgical intervention, patients were enrolled in a 12 months surveillance protocol featuring regular clinical assessments aimed at detecting ovarian reserve, pregnancy rate and any recurrence of the cyst and/or symptomatic relapse.

Measurements and Main Results

Antimullerian hormone (AMH) levels at the 3-month follow-up exhibited a significant difference from the baseline (p = .034), demonstrating a return to nearly presurgical values in the subsequent months. Antral follicle count (AFC) of the operated ovary showed a significant increase after treatment at the 6-month and 12-month follow-up (p = 0.005 and p = 0.002, respectively). Pregnancies were documented in 48.3% (14/29) of infertile patients who underwent treatment. OMA recurrence was observed in 4 patients (5.7%) at 12 months. No patient exhibited a significant relapse of the analyzed symptoms compared to baseline values.

Conclusion

The findings of this study propose that DWLS diode laser presents a good option for treating OMA, demonstrating minimal impact on the surrounding healthy ovarian tissue, favorable pregnancy rate, coupled with low recurrence rates.

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评估 DWLS 二极管激光卵巢子宫内膜异位症气化术（OMAlaser）后的卵巢储备功能和复发率：一项前瞻性、单臂、多中心临床试验。

研究目的评估双波长激光系统（DWLS）二极管激光治疗卵巢子宫内膜异位症（OMA）的效果，即在不进行剥离技术的情况下对囊囊进行消融和汽化，从而评估卵巢储备功能和复发率：前瞻性、单臂、多中心临床试验：多中心大学医院：70名无症状OMA患者：患者接受手术治疗原发性单侧或双侧无症状 OMA，采用 DWLS 二极管激光汽化治疗。手术治疗后，患者接受为期12个月的监测方案，定期进行临床评估，旨在检测卵巢储备功能、妊娠率以及囊肿复发和/或症状复发情况：随访3个月时的抗苗勒氏管激素（AMH）水平与基线值相比有显著差异（P=0.034），表明在随后的几个月中几乎恢复到手术前的水平。手术卵巢的前卵泡计数（AFC）在治疗后 6 个月和 12 个月的随访中均有显著增加（分别为 p=0.005 和 p=0.002）。在接受治疗的不孕患者中，有 48.3%（14/29）的患者怀孕。4 名患者（5.7%）在 12 个月时出现 OMA 复发。与基线值相比，没有患者出现明显的症状复发：本研究结果表明，DWLS 二极管激光是治疗 OMA 的良好选择，对周围健康卵巢组织的影响极小，妊娠率高，复发率低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.