Article (Scientific journals)
Impact on ovarian reserve and fertility using carbon dioxide laser for endometriosis treatment: a systematic review.
Giannini, Andrea; TEBACHE, Linda; Noti, Giacomo et al.
2022In Gynecological Endocrinology, 38 (8), p. 617 - 622
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Keywords :
Carbon dioxide laser; endometrioma; endometriosis; fertility; ovarian reserve; 二氧化碳激光器; 卵巢储备; 子宫内膜异位囊肿; 子宫内膜异位症; 生育能力; Carbon Dioxide; Female; Fertility; Humans; Endometriosis/complications; Endometriosis/surgery; Laparoscopy; Lasers, Gas/therapeutic use; Ovarian Diseases/complications; Ovarian Diseases/surgery; Ovarian Reserve; Lasers, Gas; Ovarian Diseases; Endocrinology, Diabetes and Metabolism; Endocrinology; Obstetrics and Gynecology
Abstract :
[en] BackgroundThe application of carbon dioxide (CO2) laser for laparoscopic gynecologic surgery was introduced in 1979 and spread after improving instrumentation, due to the versatility of the CO2 laser technology and the parallel increase of laparoscopic use. In a gynecologic setting, laser laparoscopy has been demonstrated to be effective in treating infertility and pain associated with mild to severe endometriosis.Aim and methods: This document aims at conducting a systematic review to provide a comprehensive literature overview regarding the rationale, indications, safety, and efficacy of CO2 laser treatment of endometriosis and related outcomes on ovarian reserve and fertility.ResultsCO2 laser seems to lead to lower heat damage in the ovarian tissue than bipolar energy during endometriomas treatment. Moreover, several reports have pointed out that laser vaporization allows to selectively destroy the endometrioma wall's internal surface, preserving the pericystic fibrotic capsule or the adjacent healthy ovarian cortex. Despite this, robust data we have so far indicates that the most effective laparoscopic approach for managing endometriomas is the traditional excisional technique providing better postoperative outcomes than drainage and electrocoagulation, and laser treatment. Data about fertility after treatment of deep infiltrating endometriosis (DIE) using dioxide laser are emerging but very poor.ConclusionsCurrent scientific evidence in this field is inconclusive, and the debate about the safety and efficacy of the CO2 laser on fertility outcomes is still ongoing. Further randomized case-control studies are mandatory to attain more consistent evidence.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Giannini, Andrea ;  Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
TEBACHE, Linda ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Noti, Giacomo;  Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
Cosimi, Giulia;  Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
Nisolle, Michelle ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Simoncini, Tommaso;  Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
Language :
English
Title :
Impact on ovarian reserve and fertility using carbon dioxide laser for endometriosis treatment: a systematic review.
Publication date :
August 2022
Journal title :
Gynecological Endocrinology
ISSN :
0951-3590
eISSN :
1473-0766
Publisher :
Taylor and Francis Ltd., England
Volume :
38
Issue :
8
Pages :
617 - 622
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
The author(s) reported there is no funding associated with the work featured in this article.
Available on ORBi :
since 18 January 2023

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