The Impact of Oxidized Regenerated Cellulose Application during Cystectomy and Drainage in Endometrioma Patients: A Retrospective Cohort Study.

Abstract

Objectives: This study aims to determine the impact of oxidized regenerated cellulose (ORC) during cystectomy and drainage on recurrence and ovarian reserve.

Materials and methods: Women aged 18-45 years with endometrioma (pathologically confirmed) who underwent conservative laparoscopy surgery (cystectomy and drainage) using ORC at Fatmawati General Hospital Jakarta, Indonesia, were included in this study. All surgeries were done by complete excision of all endometriosis lesions (especially for excision of deep infiltrating endometriosis and adenomyosis resection). All patients were followed up for 1 year, and the recurrence rate and postoperative anti-Mullerian Hormone (AMH) were evaluated.

Results: Twenty patients were included in the cystectomy group and 19 in the drainage group. The researchers found the result was not significant (P = 0.622) in recurrence rate. AMH was decreased from 3.0 ± 1.8 to 2.1 ± 1.5 in cystectomy with ORC group. Conversely, AMH decreased from 1.4 ± 1.25 to 1.1 ± 0.9 in the drainage with ORC group. The reduction of AMH level was more significant in the cystectomy group (P = 0.002) than in the drainage group (P = 0.124).

Conclusion: Cystectomy with ORC significantly reduces ovarian reserve. Drainage followed by insertion of ORC to the cyst cavity can be an option to maintain ovarian reserve with a risk of recurrence that is not significantly different from cystectomy.