Laparoscopic ovarian transposition for pelvic malignancies: indications and functional outcomes.
OBJECTIVE
To assess the indications and effectiveness of laparoscopic ovarian transposition before pelvic irradiation for a gynecologic cancer.


METHODS
Prospective study.


METHODS
A gynecologic oncology department in a French anti-cancer center.


METHODS
Twenty-four patients treated for pelvic cancer.


METHODS
Laparoscopic ovarian transposition to paracolic gutters. Uterine conservation in 18 patients.


METHODS
Clinical and laboratory follow-up tests of ovarian function.


RESULTS
Bilateral laparoscopic ovarian transposition was achieved in 22 patients (94%). Twelve patients were treated for clear cell adenocarcinoma of the cervix and/or upper vagina, 6 patients for invasive squamous cervical carcinoma, 3 patients for pelvic sarcoma, 1 patient for recurrent cervical cancer to the upper vagina, 1 patient for ependymoma of the cauda equina, and 1 patient for ovarian dysgerminoma. Ovarian preservation was achieved in 79%. Three pregnancies were obtained.


CONCLUSIONS
Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. Bilateral ovarian transposition should be performed. The main indications for laparoscopic ovarian transposition are a patient with a small invasive cervical carcinoma (<2 cm) in a patient <40 years of age who is treated by initial laparoscopically assisted vaginal radical hysterectomy and a patient with a clear cell adenocarcinoma of the cervix and upper vagina.
Morice
P
P
Institut Gustave Roussy, Villejuif, France.
Castaigne
D
D
Haie-Meder
C
C
Pautier
P
P
El Hassan
J
J
Duvillard
P
P
Gerbaulet
A
A
Michel
G
G
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010053:Ovary / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome