Abstract


OBJECTIVE: To compare tissue preservation and clinical outcomes of single-incision laparoscopic surgery (SILS) standard versus multi-port laparoscopy for ovarian tissue cryopreservation (OTC)in oncologic patients.
DESIGN: Retrospective cohort study at tertiary academic medical center. view more

OBJECTIVE: To compare tissue preservation and clinical outcomes of single-incision laparoscopic surgery (SILS) standard versus multi-port laparoscopy for ovarian tissue cryopreservation (OTC)in oncologic patients.
DESIGN: Retrospective cohort study at tertiary academic medical center.
MATERIALS AND METHODS: Two hundred thirty-one patients who underwent OTC from 1997 through 2017 in our tertiary medical center. Three-port laparoscopic surgery was performed in 165 (71.4%) patients and SILS was performed in 66 (28.6%) patients. Analysis included age at preservation, indication for OTC, chemotherapy prior to surgery, duration of the procedure, intra and post-operative complications, hospital stay, days from surgery to definite treatment (chemotherapy or radiation), number of oocytes and volume of tissue (assessed by number of ampules - each ampule contains 6-10 slivers for one grafting) preserved. Statistical evaluation including logistic regression was performed in order to compare the two surgical methods.
RESULTS: Number of ampules extracted from the preserved tissue was significantly higher in the SILS group compared to the standard laparoscopy group (14.7 vs. 10.6, respectively; p=0.02). Time interval (days) between surgery to definite treatment was significantly shorter in SILS group (12.2 vs 7.29 days, respectively; p<0.001). No difference was found in basic characteristics, procedure duration and overall complications rate. Regression model showed significant association between younger age and SILS with higher volume of preserved tissue
CONCLUSIONS: SILS unilateral oophorectomy is offered to patients referred for fertility preservation prior to cancer treatment. The SILS port enables to extract the ovary with one laparoscopic port without compression in an endo-bag. SILS for OTC is superior to standard laparoscopy in volume of ovarian tissue preserved. Moreover chemotherapy can be initiated sooner.

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