Laparoscopic Management of Huge Ovarian Cysts

Abstract

Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42 cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1-12 liters were drained from the cysts (mean 5.2 L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy.

Large adnexal mass: is laparoscopic surgery a safe option?

“…Laparoscopic surgery is considered as the treatment of choice in the treatment of small to moderate sized adnexal masses, but experience related to laparoscopic management for large ovarian masses remains limited. 4 The size 10cm was used as a definition for a large ovarian cyst in the present study, similar to a study done by Ou CS et al 5,6 In the present study, the mean age of the patients was 32 years and range being 14 to 43years, compared to a study by Alobaid et al, in which the mean age was 30.6 years. 2 The chief complaint was abdominal pain in 65.7% of patients in the current study, which was similar to a study by Eltabbakh et al, where in 69.7% patients presented with abdominal pain and Lim et al in which 29.6% patients presented with abdominal pain.…”

Cistoadenoma seroso ovárico gigante en la posmenopausia. Reporte de un caso

“…La cirugía es esencial para los tumores de ovario grandes, incluso si es benigna. Hasta ahora, no ha habido un ensayo controlado aleatorio para el tratamiento laparoscópico de quistes ováricos> 20 cm, por lo que la laparotomía siguió siendo el método ideal para la escisión de los quistes ováricos gigantes 11 .…”

“…Los tumores serosos se ven comúnmente durante el período reproductivo, ocurren en adultas de todas las edades, con edades medias reportadas que difieren de 40 a 60 años; y en el 50% de ellos ocurren antes de los 40 años. La mayoría de estos quistes son de naturaleza benigna, con una probabilidad de malignidad de solo 7% -13% en premenopáusicas y 8% -45% en mujeres posmenopáusicas [9][10][11] .…”

“…En relación al uso de marcador tumoral CA-125, es una herramienta útil que ayuda a distinguir entre masas ováricas benignas y malignas. Cabe mencionar que, en la mayoría de los reportes 9,11,16,17 de cistoadenomas serosos, el CA-125 estuvo dentro del rango normal o aumentó levemente.…”

Giant Ovarian Cyst Presenting With Colon Cancer

“…Traditionally, all giant cysts were treated with laparotomy, but laparoscopy has become popular and may be appropriate in certain cases, especially uncomplicated smaller cysts. Laparoscopy may be appropri- ate for patients with a very low risk of malignancy, and has been well documented in premenopausal patients [12,13]. Accurate staging of ovarian tumors is also similar between laparotomy and laparoscopy; however laparoscopy is associated with higher rates of tumor rupture [14].…”