[Operative technique for assumed benign ovarian cysts].
Assumed benign ovarian cysts are best treated by laparoscopy rather than laparotomy (NP1). A peritoneal sampling for cytology should always be performed first (NP5). Frozen section diagnosis for suspicion of malignancy requires specific conditions (NP5). Laparoscopic treatment of macroscopically functional cysts can not be limited to needle aspiration (NP5). There is not enough evidence to privilege cystectomy after needle aspiration over attempt to achieve enucleation of the cyst; however, uncontrolled rupture of the cyst is the risk associated with the latter procedure (NP5). Authors usually recommend extraction of the cyst through a bag (NP5). There is not enough evidence for or against ovarian suture. Benefits of adhesion barriers after ovarian cystectomy has to be proved. The majority of the authors perform a bilateral oophorectomy in case of unilateral postmenopausal cyst (NP5). As much parenchyma as possible should be preserved in case of large ovarian cysts. For women with small controlateral dermoid cysts, the validity of surgical abstention is not established. Conservative surgery is the rule in case of premenopausal mucinous cysts.
Vaudoyer
F
F
Service de Gynécologie Obstétrique, Hôtel Dieu, 69002 Lyon.
Golfier
F
F
Raudrant
D
D
D001706:Biopsy; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms; D010052:Ovariectomy; D017698:Postmenopause; D012422:Rupture, Spontaneous; D013396:Suction; D014102:Torsion Abnormality
Technique opératoire des kystes ovariens supposés bénins.