A Randomized Control Trial Comparing Direct Stripping and Bipolar Electrocoagulation for Laparoscopic Endometriotic Cystectomy-Surgical and Histopathological Aspects

Abstract

The present study compared two different techniques of endometriotic cystectomy at the hilus : continuation of strip-ping and bipolar elctrocoagulation and cuttin . This was a randomized controlled study was done on 64 patients, who had laparoscopically confirmed endometriomas > 3 cm in diameter. Endometriotic cystectomy was initiated by excision of a circular rim of tissue at the original adhesion site followed by stripping and randomization was done at the ovarian hilum into 2 groups. In Group I surgery was completed by continuation of stripping and in group II surgery was completed by bipolar coagulation and cutting with scissors. Operative time and operative difficulty were evaluated at both steps by the same surgeon. Histopathology confirmation of the loss of normal ovarian tissue was recorded in the excised cyst and at the hilus separately. Data was analysed using Stata software, fisher’s exact test was employed to assess operative difficulty and Kruskal-Wallis test was used to evaluate ovarian tissue quality. The mean operating time was reported to be significantly lesser in the coagulation and cutting group. The operative difficulty was comparable in two groups. The number of primordial follicles sacrificed showed no significant difference in both groups. Complication rate in terms of hemorrhage was higher in the direct stripping group.