Pelviscopic treatment of ovarian cysts in premenopausal women.
Between 1984 and 1989, 773 patients less than or equal to 45 years of age, presenting with a total of 809 ovarian cysts, underwent pelviscopy at the Department of Obstetrics and Gynecology of Kiel University. In 36 cases, cysts were bilateral. 678 cysts (84%) were treated by pelviscopy alone. Organ-preserving treatment was performed in 83%, oophorectomy or adnexectomy in only 17% of cases. Two stage Ia ovarian carcinomas (0.26% of all cysts) were operated on by pelviscopy before laparotomy. Sonography is particularly important in determining whether a pelviscopic approach is appropriate. Pelviscopic procedures are unacceptable in multilocular cysts measuring greater than or equal to 7 cm in diameter with echo-dense components. Special caution is required for any cyst measuring greater than 9 cm in diameter. The risk of opening a malignant cyst must be weighed against the advantages of pelviscopic surgery: minimal physical strain, better postoperative quality of life, and organ conservation. In doubtful cases, laparotomy is recommended.
Mecke
H
H
Department of Obstetrics and Gynecology, Kiel University, FRG.
Lehmann-Willenbrock
E
E
Ibrahim
M
M
Semm
K
K
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000367:Age Factors; D003536:Cystadenocarcinoma / Q000473:pathology / Q000601:surgery; D003537:Cystadenoma / Q000473:pathology / Q000601:surgery; D005260:Female; D005350:Fibroma / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008593:Menopause; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014463:Ultrasonography