Should We Manage Large Ovarian Cysts Laparoscopically?

ChopadeGaurav,; PatilSaurabh,; DasTanuka,; ThomasManju,; GargReena,

doi:10.1089/gyn.2016.0009

Cited by 8 publications

(6 citation statements)

References 20 publications

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“…10 Adnexectomy should be considered a better option for suspicious cases ,provided that the contralateral ovaries are normal. 11 According to Fauvet et al, for the management of borderline malignancy laparoscopic cystectomy or adnexectomy is preferred and patient survival is not affected, although the risk of recurrence was high in that study's cystectomy group. 12 Tumour recurrence and metastatic disease are rare in borderline ovarian tumors.…”

Section: Discussionmentioning

confidence: 79%

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Large adnexal mass: is laparoscopic surgery a safe option?

Talwar

Shree

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Laparoscopic surgery is regarded as the gold standard for management of adnexal tumours due to many advantages. Currently, the exact size of the adnexal tumour contraindicating laparoscopic management has not been clearly defined. Some studies suggest laparotomy for the treatment of adnexal tumours larger than 8 to 10 cm. Risk of malignancy increases with large cysts. Issues with operation of huge adnexal masses are limited surgical field, difficulty in inserting trocars and removing the specimen without rupture. This study aims to evaluate the feasibility and surgical outcomes of laparoscopic surgery for large adnexal masses.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, JSS Medical College, Mysuru.Results: 35 patients with large adnexal masses, which were thought to be benign, were subjected to laparoscopic surgery. Mean diameter of masses as per the pre-operative ultrasound measurements was 12.2cm (range: 10.1-20.4cm). The mean operative time was 51.15minutes, estimated blood loss was 85.4ml, duration of postoperative hospital stay was 2.8 days. Serous cystadenoma was the most common histopathological finding. However, one case of borderline tumour was found.Conclusions: The potential risk of malignancy is the most important limiting factor for laparoscopic management of large ovarian cysts. Therefore, it is necessary to establish risk profiles of patients with adnexal masses in order to benefit from minimally invasive surgery wherever possible. The current study supports laparoscopic management of large ovarian cysts as a technically feasible method if proper case selection is made.

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Section: Discussionmentioning

confidence: 79%

“…12 Tumour recurrence and metastatic disease are rare in borderline ovarian tumors. 13,14 11 3.7 2.5 Paul et al 14 9.09 None Current study 2.8 None…”

Section: Discussionmentioning

confidence: 98%

Large adnexal mass: is laparoscopic surgery a safe option?

Talwar

Shree

2019

Int J Reprod Contracept Obstet Gynecol

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“…Some evidence has suggested laparotomy to remove ovarian masses over 10cm in size. 12 In our case report, a laparotomy intervention was performed because the cyst size was estimated to be more than 10 cm in the ultrasound.…”

Section: Discussionmentioning

confidence: 86%

Torsion of a large ovarian dermoid cyst in the second trimester of pregnancy and its management: a case report

Nia¹

2020

IPCB

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Background: The Dermoid cyst is the most common ovarian germ cell tumor in pregnant women. During pregnancy, the risk of complications such as torsion, rupture,and infection increases in dermoid cysts. Treatment includes follow-up or surgical intervention. The present study reports a case of a large ovarian dermoid cyst in pregnancy and its treatment. Case report: An 18-year-old primiparous woman presented with nausea and severe abdominal pain in the lower left quadrant. On a deep abdominal examination, there was a palpable mass in the area. Ultrasound showed left ovarian torsion of a large dermoid cyst 10×11cm in size. The patient underwent a laparotomy and with the left ovary preserved, the cyst was removed. Ultrasound showed fetal health a few days after surgery. Conclusion: gynecologists should be aware of the possibility of acute ovarian torsion in pregnant women and should have a high level of suspicion. Early surgical intervention reduces the risk of complications

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“…3 Some surgeons limited laparoscopic surgery to ovarian cyst of size less than 10 cm. [4][5][6][7] For apparently benign, extremely large ovarian cysts, only few surgeons advocate laparoscopic management.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of large benign ovarian cysts

Sidhmalswamy

Ghongdemath²

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Laparoscopy has become an accepted method of management of ovarian cysts. Objective of present study was to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.Methods: Ten patients from May 2014 to April 2015, with large ovarian cysts, with diameter >10 cm, were managed laparoscopically. All the masses were cystic and were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA 125 levels were within the normal range (0-35 U/mL). Preoperative evaluation included history, clinical examination, sonographic images and serum markers. The management of these ovarian cysts included aspiration, cystectomy or salphingo-oophorectomy, depending on the patient's age, obstetric history and desire of future fertility.Results: Seven patients presented with pain abdomen, 3 patients with abdominal distension and discomfort. The average maximum diameter of the ovarian cysts was 14.75 cm (range, 10-22 cm). The mean duration of the operation was 80 minutes (60 -120 min). The postoperative hospital stay was 2 days. No intraoperative complications occurred, and the hospital course of all patients was uncomplicated. The patients did not report any complaints during follow-up and the clinical examination findings were normal in all, up to 9 months after discharge.Conclusions: With proper patient selection, the size of an ovarian cyst is not necessarily a contraindication for laparoscopic surgery.

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Should We Manage Large Ovarian Cysts Laparoscopically?

Cited by 8 publications

References 20 publications

Large adnexal mass: is laparoscopic surgery a safe option?

Large adnexal mass: is laparoscopic surgery a safe option?

Torsion of a large ovarian dermoid cyst in the second trimester of pregnancy and its management: a case report

Laparoscopic management of large benign ovarian cysts

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