Ovarijalna rezerva kod bolesnica operisanih od endometrioze

  • Olivera Džatić Smiljković Medical Faculty University of Belgrade University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
  • Mladenko Vasiljević University of Belgrade, Faculty of Medicine, University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
  • Ivana Rudić University of Belgrade, Faculty of Medicine, University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
  • Jelena Vugdelić University of Belgrade, Faculty of Medicine, University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
  • Aleksandar Ristić University of Belgrade, Faculty of Medicine, University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
  • Rada Vugdelić University of Belgrade, Faculty of Medicine, University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP160408363D
Ključne reči: endometrioza;, neplodnost;, laparoskopija;, cistektomija;, cistotomija;, lečenje, ishod.

Sažetak


Uvod/Cilj. Endometrioza je ginekološko oboljenje koje karakteriše prisustvo endometrijalnog tkiva van materične šupljine. Cilj ovog rada bio je da se utvrdi uticaj laparoskopske cistotomije i cistektomije na funkciju jajnika, kao i da se uporede ove dve metode, po pitanju kvalitativnog i kvantitativnog oštećenja jajnika, ostva­renih trud­noća i recidiva. Metode. Sprovedena je prospektivna stu­dija u Ginekološko-akušerskoj klinici (GAK) „Narodni Front“ u Beogradu, u Odeljenju za endoskopsko lečenje infertiliteta. Studijom je bilo obuhvaćeno ukupno 150 bolesnica. Ispitivanu grupu je sačinjavalo 100 bolesnica koje su operisane zbog postojanja endometriotičnih cista na jajniku. Bolesnice ispitivane grupe su podeljene u dve pod­grupe: podgrupu I sačinjavalo je 50 operisanih bolesnica kod kojih je urađena laparo­skopska incizija ciste sa termokoagulacijom (cisto­to­mi­ja), dok je podgrupa II obuhvatila 50 operisanih boles­nica kod kojih je urađena laparo­skopska cistektomija. Kontrolnu grupu su činile bolesnice operisane zbog tubarnog faktora infertiliteta. Ispitivani su parametri ovarijalne funkcije: volumen jajnika, broj antralnih folikula, prisustvo preovulatornog folikula na operisanom jajniku, serumski nivoi anti-milerovog hor­mona (AMH), folikulostimulirajućeg hormona (FSH), inhibina B, tumorskog markera jajnika (CA 125), kao i stopa ostvarenih trudnoća nakon operacije. Rezultati. Volumen jajnika i broj antralnih folikula kao i vrednosti FSH su bili značajno veći u kontrolnoj grupi u odnosu na ispitivanu grupu bolesnica. Nije nađena značajna razlika u volumenu jajnika, broju antralnih folikula, vrednostima AMH i Inhibina B u ispitivanoj grupi bolesnica između onih sa cistektomijom i onih sa incizijom i koagulacijom ciste. Zaključak. Obe operativne tehnike smanjuju ova­rijalnu rezervu: cistektomija je agresivnija metoda u smislu oštećenja tkiva jajnika, a incizija nosi veći rizik od recidiva.

 

Biografija autora

Olivera Džatić Smiljković, Medical Faculty University of Belgrade University Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
Head of ultrasound department

Reference

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Objavljeno
2021/01/26
Broj časopisa
Vol. 75 Br. 7 (2018): Vojnosanit Pregl 2018; July Vol. 75 (No. 7)
Rubrika
Originalni članak