Influence of endomeriotic cyst diameter and the severity of endometriosis on the ovarian parenchyma excised during laparoscopic cystectomy

Effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cyst

OBJECTIVE

This study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts.

MATERIAL AND METHODS

This prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision.

RESULTS

Laparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction.

CONCLUSION

The number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.

Effect of different doses of dezocine on recovery quality from general anesthesia in patients undergoing laparoscopic surgery

AIM

To investigate the effect of different doses of dezocine on the recovery quality from general anesthesia in patients undergoing laparoscopic surgery (LS).

METHODS

Sixty patients who underwent elective LS under general anesthesia, aged from 20 to 65 years, were randomly allocated to three groups to receive intravenous dezocine 0.1 mg/kg (L group, n = 20), dezocine 0.2 mg/kg (H group, n = 20) or saline solution (C group, n = 20) 15 min before the surgery finished, respectively. The general data of the patients and adverse reactions during the anesthesia recovery period were recorded, and the mean arterial pressure (MAP), heart rate (HR), and verbal rating scales (VRS) were also recorded at different time points as follows: before anesthesia induction (T₀), the time of extubation (T₁), 5 min (T₂), 15 min (T₃), and 30 min (T₄) following extubation.

RESULTS

The incidence of emergence agitation in the L group and H group were significantly lower than that in the C group (P < 0.05), and the incidence of drowsiness and respiratory depression in the H group was significantly higher than that in the other two groups (P < 0.05), while the incidence of nausea and vomiting had no significant difference in the three groups (P > 0.05). The MAP and HR at T₁ were higher than those at T₀ in the C group (P > 0.05). VRS at other time points were significantly higher than those at T₀ in the three groups. Compared with the C group, the MAP and HR had no obvious changes in the L group and H group, while VRS were significantly lower at T₁-T₄ (P < 0.05).

CONCLUSION

Before the end of surgery, 0.1 mg/kg of intravenous dezocine may relieve early postoperative pain and reduce emergence agitation with a lower rate of adverse reactions in patients undergoing LS.

Effect of mode of anesthesia on digestive system and quality of life in patients undergoing laparoscopic surgery

AIM

To observe the effect of different anesthesia methods on the digestive system and quality of life in patients undergoing laparoscopic surgery (LS).

METHODS

Sixty patients undergoing LS at our hospital from January 2015 to June 2016 were divided into either a control group (n = 30) or an observation group (n = 30) according to the mode of anesthesia. The control group was anesthetized with sevoflurane, and the observation group was anesthetized with propofol and remifentanil. Digestive system adverse events were compared between the two groups. The quality of life was assessed using a questionnaire.

RESULTS

The percentage of patients with digestive system adverse reactions after anesthesia was 13.33% in the observation group, significantly lower than the percentage (30.00%) in the control group (P < 0.05). Postoperative quality of life scores including physiological, psychological, social relations, environment and quality of life scores were significantly lower in the observation group than in the control group (P < 0.05).

CONCLUSION

Anesthesia using propofol with remifentanil during LS has ideal effects with regards to low incidence of digestive system adverse reactions and high quality of life.