Laparoscopic management of women with a family history of ovarian cancer.
OBJECTIVE
The safety of laparoscopic surgery in women with a family history of ovarian cancer predicted to have benign disease has not been established. The objective of this study was to evaluate the feasibility and complications of operative laparoscopy and to describe the pathologic findings in this patient population.


METHODS
Sixty-two consecutive women with a family history of ovarian cancer who elected prophylactic oophorectomy or had predicted benign adnexal disease were offered laparoscopic surgery. Patient characteristics, details of laparoscopic surgery, operative and postoperative complications, and histopathologic findings were recorded.


RESULTS
Laparoscopy was converted to laparotomy in 2 patients (3.2%); 1 patient (1.6%) had an operative vascular complication, and 1 patient (1.6%) had postoperative bleeding. Median (range) estimated blood loss, operative time, and hospital stay were 50 ml (50-1,500), 120 min (60-290), and 1 day (0-9), respectively. Histopathologic findings included normal ovaries (n = 20), corpus luteum cyst (n = 16), follicular cyst (n = 8), endometriotic cyst (n = 7), serous cystadenoma (n = 5), epithelial hyperplasia (n = 4), dermoid cyst (n = 1), and fibrothecoma (n = 1).


CONCLUSIONS
Laparoscopic surgery is feasible and safe in women with a family history of ovarian cancer predicted to have benign disease and is associated with low blood loss and short hospital stay. Most ovaries removed are either normal or have benign disease.
Eltabbakh
G H
GH
Division of Gynecologic Oncology, University of Vermont, Burlington, Vermont 05401, USA.
Piver
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Hempling
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Recio
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Paczos
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D000328:Adult; D000368:Aged; D024682:BRCA2 Protein; D005240:Feasibility Studies; D005260:Female; D019398:Genes, BRCA1; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000592:standards / Q000706:statistics & numerical data; D008487:Medical History Taking; D008593:Menopause; D008875:Middle Aged; D009017:Morbidity; D009363:Neoplasm Proteins / Q000235:genetics; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000601:surgery*; D010052:Ovariectomy / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D014157:Transcription Factors / Q000235:genetics
D024682:BRCA2 Protein; D009363:Neoplasm Proteins; D014157:Transcription Factors