title: Laparoscopic management of adnexal masses suspicious at ultrasound.
abstract: OBJECTIVE
  To evaluate the laparoscopic management of adnexal masses suspicious at ultrasound.
  
  
  METHODS
  In a prospective study, adnexal masses suspicious at ultrasound were managed by laparoscopy. Indications for laparotomy included general contraindications to laparoscopy, obviously disseminated ovarian cancer, and technically impossible laparoscopic treatment. After laparoscopic diagnosis, frozen sections were used to confirm a diagnosis of malignancy. Treatment was performed by laparoscopy whenever feasible.
  
  
  RESULTS
  Over a 3-year period, 247 of the 599 adnexal masses (41.2%) treated in our department were suspicious or solid at ultrasound. Seventeen patients were evaluated by laparotomy and 230 by laparoscopy. Overall, 204 women (82.6%) were treated by laparoscopy, including seven of the 37 malignant tumors (18.9%) and 197 of the 210 benign masses (93.8%). One case of tumor dissemination occurred after a laparoscopic adnexectomy and morcellation of a grade 1 immature teratoma.
  
  
  CONCLUSIONS
  Laparoscopic diagnosis of adnexal masses suspicious at ultrasound avoids many laparotomies for the treatment of benign masses and allows an improved inspection of the upper abdomen. The laparoscopic treatment of adnexal masses suspicious at surgery should be evaluated further in carefully designed prospective studies.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Polyclinique de l'Hotel Dieu, Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Canis
authors.forename: J L
authors.initials: JL
authors.lastname: Pouly
authors.forename: A
authors.initials: A
authors.lastname: Wattiez
authors.forename: G
authors.initials: G
authors.lastname: Mage
authors.forename: H
authors.initials: H
authors.lastname: Manhes
authors.forename: M A
authors.initials: MA
authors.lastname: Bruhat
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D001706:Biopsy; D000075202:Contraindications; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy; D008875:Middle Aged; D009366:Neoplasm Seeding; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography