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Is tumor size the limiting factor in a laparoscopic management for large ovarian cysts?

Purpose To assess the feasibility and short-term surgical outcome of laparoscopic surgery among women with large ovarian cysts. Methods We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features su...

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Published in:Archives of gynecology and obstetrics 2012-11, Vol.286 (5), p.1227-1232
Main Authors: Lim, Soyi, Lee, Kwang-Beom, Chon, Seung-Ju, Park, Chan-Yong
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description Purpose To assess the feasibility and short-term surgical outcome of laparoscopic surgery among women with large ovarian cysts. Methods We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features suggestive of malignancy, from March 2008 to September 2011. Results Laparoscopic surgery was successful in 77 (95.1 %) of the total patients. The mean (range) operative time, estimated blood loss (EBL) and hospital stay were 107.6 (55–250 min), 226.9 (10–1300 mL) and 6.1 (4–15 days), respectively. The surgical procedures performed included salpingooophorectomy (SO) ( n  = 44), ovarian cystectomy (OC) ( n  = 22), adhesiolysis ( n  = 1), salpingectomy ( n  = 2) and total laparoscopic hysterectomy (TLH) with SO ( n  = 8). Conversion to laparotomy occurred with four patients. One patient had postoperative bleeding and one had minor complications associated with wound oozing at the umbilical port site. Histopathological examination revealed benign tumors in 76 patients (93.8 %), borderline ovarian tumor in three patients (3.7 %) and invasive epithelial ovarian cancer in two patients (2.5 %). Clinicopathological variables according to tumor size were not statistically different. Complications did not appear in any patients during the follow-up period. Conclusion With proper patient selection, laparoscopy is a feasible and safe treatment for women with large ovarian cysts and tumor size did not have effect on laparoscopic management. However, surgeons should carefully consider the potential risk of malignancy in such patients.
doi_str_mv 10.1007/s00404-012-2445-9
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Methods We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features suggestive of malignancy, from March 2008 to September 2011. Results Laparoscopic surgery was successful in 77 (95.1 %) of the total patients. The mean (range) operative time, estimated blood loss (EBL) and hospital stay were 107.6 (55–250 min), 226.9 (10–1300 mL) and 6.1 (4–15 days), respectively. The surgical procedures performed included salpingooophorectomy (SO) ( n  = 44), ovarian cystectomy (OC) ( n  = 22), adhesiolysis ( n  = 1), salpingectomy ( n  = 2) and total laparoscopic hysterectomy (TLH) with SO ( n  = 8). Conversion to laparotomy occurred with four patients. One patient had postoperative bleeding and one had minor complications associated with wound oozing at the umbilical port site. Histopathological examination revealed benign tumors in 76 patients (93.8 %), borderline ovarian tumor in three patients (3.7 %) and invasive epithelial ovarian cancer in two patients (2.5 %). Clinicopathological variables according to tumor size were not statistically different. Complications did not appear in any patients during the follow-up period. Conclusion With proper patient selection, laparoscopy is a feasible and safe treatment for women with large ovarian cysts and tumor size did not have effect on laparoscopic management. However, surgeons should carefully consider the potential risk of malignancy in such patients.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-012-2445-9</identifier><identifier>PMID: 22791381</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adenocarcinoma, Mucinous - drug therapy ; Adenocarcinoma, Mucinous - pathology ; Adenocarcinoma, Mucinous - surgery ; Adolescent ; Adult ; Aged ; Analysis of Variance ; Blood Loss, Surgical ; Carcinoma, Ovarian Epithelial ; Cysts ; Endocrinology ; Female ; General Gynecology ; Gynecology ; Human Genetics ; Humans ; Hysterectomy ; Laparoscopy ; Laparoscopy - adverse effects ; Length of Stay ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neoplasms, Glandular and Epithelial - drug therapy ; Neoplasms, Glandular and Epithelial - pathology ; Neoplasms, Glandular and Epithelial - surgery ; Obstetrics/Perinatology/Midwifery ; Operative Time ; Ovarian cancer ; Ovarian Cysts - pathology ; Ovarian Cysts - surgery ; Ovarian Neoplasms - drug therapy ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - surgery ; Ovariectomy ; Patients ; Retrospective Studies ; Salpingectomy ; Tissue Adhesions - surgery ; Tumor Burden ; Young Adult</subject><ispartof>Archives of gynecology and obstetrics, 2012-11, Vol.286 (5), p.1227-1232</ispartof><rights>Springer-Verlag 2012</rights><rights>Archives of Gynecology and Obstetrics is a copyright of Springer, (2012). 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Methods We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features suggestive of malignancy, from March 2008 to September 2011. Results Laparoscopic surgery was successful in 77 (95.1 %) of the total patients. The mean (range) operative time, estimated blood loss (EBL) and hospital stay were 107.6 (55–250 min), 226.9 (10–1300 mL) and 6.1 (4–15 days), respectively. The surgical procedures performed included salpingooophorectomy (SO) ( n  = 44), ovarian cystectomy (OC) ( n  = 22), adhesiolysis ( n  = 1), salpingectomy ( n  = 2) and total laparoscopic hysterectomy (TLH) with SO ( n  = 8). Conversion to laparotomy occurred with four patients. One patient had postoperative bleeding and one had minor complications associated with wound oozing at the umbilical port site. Histopathological examination revealed benign tumors in 76 patients (93.8 %), borderline ovarian tumor in three patients (3.7 %) and invasive epithelial ovarian cancer in two patients (2.5 %). Clinicopathological variables according to tumor size were not statistically different. Complications did not appear in any patients during the follow-up period. Conclusion With proper patient selection, laparoscopy is a feasible and safe treatment for women with large ovarian cysts and tumor size did not have effect on laparoscopic management. 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Methods We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features suggestive of malignancy, from March 2008 to September 2011. Results Laparoscopic surgery was successful in 77 (95.1 %) of the total patients. The mean (range) operative time, estimated blood loss (EBL) and hospital stay were 107.6 (55–250 min), 226.9 (10–1300 mL) and 6.1 (4–15 days), respectively. The surgical procedures performed included salpingooophorectomy (SO) ( n  = 44), ovarian cystectomy (OC) ( n  = 22), adhesiolysis ( n  = 1), salpingectomy ( n  = 2) and total laparoscopic hysterectomy (TLH) with SO ( n  = 8). Conversion to laparotomy occurred with four patients. One patient had postoperative bleeding and one had minor complications associated with wound oozing at the umbilical port site. Histopathological examination revealed benign tumors in 76 patients (93.8 %), borderline ovarian tumor in three patients (3.7 %) and invasive epithelial ovarian cancer in two patients (2.5 %). Clinicopathological variables according to tumor size were not statistically different. Complications did not appear in any patients during the follow-up period. Conclusion With proper patient selection, laparoscopy is a feasible and safe treatment for women with large ovarian cysts and tumor size did not have effect on laparoscopic management. However, surgeons should carefully consider the potential risk of malignancy in such patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22791381</pmid><doi>10.1007/s00404-012-2445-9</doi><tpages>6</tpages></addata></record>
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subjects Adenocarcinoma, Mucinous - drug therapy
Adenocarcinoma, Mucinous - pathology
Adenocarcinoma, Mucinous - surgery
Adolescent
Adult
Aged
Analysis of Variance
Blood Loss, Surgical
Carcinoma, Ovarian Epithelial
Cysts
Endocrinology
Female
General Gynecology
Gynecology
Human Genetics
Humans
Hysterectomy
Laparoscopy
Laparoscopy - adverse effects
Length of Stay
Medicine
Medicine & Public Health
Middle Aged
Neoplasms, Glandular and Epithelial - drug therapy
Neoplasms, Glandular and Epithelial - pathology
Neoplasms, Glandular and Epithelial - surgery
Obstetrics/Perinatology/Midwifery
Operative Time
Ovarian cancer
Ovarian Cysts - pathology
Ovarian Cysts - surgery
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
Ovariectomy
Patients
Retrospective Studies
Salpingectomy
Tissue Adhesions - surgery
Tumor Burden
Young Adult
title Is tumor size the limiting factor in a laparoscopic management for large ovarian cysts?
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