Objective To analyze effect of varied surgeries the changes of serum anti-mullerian hormone (AMH) and influencing factors of adverse pregnancy in patients with ovarian chocolate cyst after laparoscopic surgery.
Methods The clinical data of 102 patients with ovarian chocolate cyst treated in Bozhou People's Hospital were collected retrospectively. They were divided into laparoscopy group (70 cases) and laparotomy group (32 cases) according to the operation methods. The laparoscopic group was treated with laparoscopic ovarian chocolate cyst exfoliation, and the open group was treated with laparotomy. The clinical indexes and the changes of serum AMH before and after operation were compared between the two groups, and the influencing factors of postoperative adverse pregnancy outcomes in patients with ovarian chocolate cyst were analyzed.
Results The operation time (51.34±5.82) min, intraoperative bleeding (27.83±5.62) mL, hospital stay (6.99±1.39) d and exhaust time (10.71±1.63) h in the laparoscopic group were significantly lower or shorter than (79.97±6.98) min, (50.16±15.24) mL, (11.66±1.49) d and (26.75±3.69) h in the open group (P < 0.05). After surgery, AMH levels in the laparoscopic group and the open group were (2.51±1.41) and (1.84±1.23) ng/mL, respectively, which were lower than those before surgery, but the above indicators in the laparoscopic group were higher than those in the open group (P < 0.05). Multivariate Logistic regression analysis showed that age, course of disease, side of cyst, pelvic adhesion, fallopian tube function, preoperative infertility, postoperative assisted pregnancy, surgical method and AMH level were all independent influencing factors of postoperative adverse pregnancy outcomes (P < 0.05). The area under the curve for preoperative AMH level in predicting postoperative adverse pregnancy outcome was 0.704, the specificity was 0.859, the sensitivity was 0.763, and the threshold was 1.765.
Conclusion Compared with laparotomy, laparoscopic chocolate cyst removal of ovary has less effect on serum AMH levels and better perioperative indicators. Age, course of disease, side of cyst, pelvic adhesion, fallopian tube function, preoperative infertility, postoperative assistance for pregnancy, surgical method and AMH level can all affect the postoperative pregnancy outcomes of chocolate ovarian cyst patients, and preoperative AMH level can be used as a clinical indicator to predict postoperative adverse pregnancy outcomes.
DownLoad: