Laparoscopic management of suspicious adnexal masses.
OBJECTIVE
Our aim was to evaluate the feasibility and applicability of operative laparoscopy in the management of adnexal masses that do not meet the standard serum CA 125 and ultrasonographic criteria for benignity.


METHODS
One hundred thirty-eight patients underwent operative laparoscopy for removal of suspicious adnexal masses. The CA 125 level was > 35 mlU/ml in 39 of 138 (28%) patients; ultrasonographic findings were abnormal in 127 of 138 (92%); masses were > 10 cm in 43 of 138 (32%) of patients.


RESULTS
Malignancies were discovered in 14% (19/138) of patients. Eight percent (11/138) of the procedures were converted to laparotomy, six because of inability to dissect the mass laparoscopically and five for staging or debulking of carcinoma. Operative times ranged from 25 to 210 minutes, with a mean of 86. Three major complications were encountered-an enterotomy and a lacerated vena cava, both of which were repaired laparoscopically, and a small bowel herniation through a lateral port site that required reoperation. Hospital stays ranged from 0 to 11 days, with a mean of 1.5. In two patients with "apparent" stage I adnexal carcinomas recurrence was diagnosed 6 and 38 months after surgery.


CONCLUSIONS
Laparoscopic management of suspicious adnexal masses is technically feasible, with a low rate of morbidity and a short hospital stay. Adnexal carcinomas can be identified and managed appropriately with staging and complete resection as indicated.
Childers
J M
JM
Department of Obstetrics and Gynecology, University of Arizona, Tucson, USA.
Nasseri
A
A
Surwit
E A
EA
D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood; D002648:Child; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D014463:Ultrasonography
D018394:CA-125 Antigen