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Abstract：
Background Salpingectomy is a common surgical procedure in gynecology performed for various indications. Given its proximity to the ovaries and shared vascular supply, concerns have arisen regarding compromised ovarian reserve post-salpingectomy. Objective We aim to study the effect of two different energy sources (group 1: salpingectomy using bipolar electrocautery followed by division with scissors versus group 2: salpingectomy with ultrasonic shears) on residual ovarian reserve. The effect on ovarian reserve was assessed using serum levels of follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), antral follicle count (AFC), and ovarian size pre- and postoperatively. Materials and methods According to the inclusion criteria, 68 women were included in the study and randomized into the bipolar electrocautery group and the ultrasonic shear group. The final analysis included 34 women in the bipolar electrocautery group and 32 in the ultrasonic shear group. Preoperatively, the ovarian reserve of all women was assessed using FSH, AMH, AFC, and ovarian size. These parameters were then reassessed at three months postoperatively, and the percentage change was analyzed. Results The mean baseline serum AMH and serum FSH values in the bipolar electrocautery group were 3.9 ± 2.9 ng/ml and 6.6 ± 2.1 IU/L, respectively, comparable with the values in the ultrasonic shear group, where serum AMH was 3.2 ± 2.9 ng/ml and serum FSH was 7.3 ± 3.9 IU/L. AFC and ovarian size were comparable between the two groups preoperatively (bipolar electrocautery group AFC was 8 ± 2.2, ovarian size on the right side was 3.3 ± 0.7 cm and on the left was 3.2 ± 0.6 cm; ultrasonic shear group AFC was 5.7 ± 2.3, ovarian size on the right side was 3.4 ± 0.8 cm and on the left was 3.2 ± 0.8 cm). After three months of postoperative analysis, AFC showed a significant fall from the preoperative value in the bipolar electrocautery group compared to the ultrasonic shear group (AFC reduced from 8 ± 2.2 to 5.5 ± 2.3 vs. 8.6 ± 0.5 to 7.9 ± 2.3; p=0.002). The other parameters showed no statistically significant change. Conclusion Our study suggests that ultrasonic shear is safer than bipolar electrocautery for preserving ovarian reserve after salpingectomy. However, further research is needed to confirm these findings.
摘要：
背景输卵管切除术是妇科常见的手术方法，用于各种适应症。鉴于它靠近卵巢和共享血管供应，人们对输卵管切除术后卵巢储备功能受损表示担忧.目的我们旨在研究两种不同能量来源（第1组：使用双极电灼术进行输卵管切除术，然后用剪刀分割，第2组：使用超声剪刀进行输卵管切除术）对残余卵巢储备的影响。使用血清卵泡刺激素（FSH）水平评估对卵巢储备的影响，抗苗勒管激素（AMH），窦卵泡计数（AFC），术前和术后卵巢大小。材料和方法根据纳入标准，68名妇女被纳入研究，并随机分为双极电灼术组和超声剪切组。最终分析包括双极电灼术组的34名女性和超声剪切组的32名女性。术前,使用FSH评估所有女性的卵巢储备，AMH,AFC,和卵巢大小。然后在术后三个月重新评估这些参数，并分析了百分比变化。结果双极电灼术组血清AMH和FSH基线值分别为3.9±2.9ng/ml和6.6±2.1IU/L,分别,与超声剪切组的值相当，其中血清AMH为3.2±2.9ng/ml，血清FSH为7.3±3.9IU/L。术前两组AFC和卵巢大小相当（双极电灼组AFC为8±2.2，右侧卵巢大小为3.3±0.7cm，左侧卵巢大小为3.2±0.6cm；超声剪切组AFC为5.7±2.3，右侧卵巢大小为3.4±0.8cm，左侧卵巢大小为3.2±0.8cm）。经过三个月的术后分析，与超声剪切组相比，双极电灼术组的AFC显示出术前价值显着下降（AFC从8±2.2降低至5.5±2.3vs.8.6±0.5至7.9±2.3；p=0.002）。其他参数无统计学意义的变化。结论我们的研究表明，在输卵管切除术后保留卵巢储备方面，超声切刀比双极电刀更安全。然而,需要进一步的研究来证实这些发现.
