Efficacy of laparoscopically-assisted extracorporeal cystectomy in patients with ovarian endometrioma.
OBJECTIVE
To investigate the usefulness and effectiveness of the extracorporeal surgical technique in the treatment of endometriomas.


METHODS
Retrospective evaluation (Canadian Task Force Classification II-2).


METHODS
Department of gynecology in a tertiary care faculty hospital and training hospital.


METHODS
Of 89 patients with endometrioma, 53 had laparoscopic stripping, and 36 had laparoscopically-assisted extracorporeal cystectomy.


METHODS
Laparoscopic stripping and laparoscopically-assisted extracorporeal cystectomy were performed for the treatment of endometriomas diagnosed laparoscopically.


RESULTS
The size of the endometrioma diagnosed by the ultrasonographic examination was not statistically related to the severity of the endometriosis (p = .42). Conversion to extracorporeal technique was required in 17 of 58 cases with moderate endometriosis and 14 of 31 cases with severe endometriosis (p = .04). Operation time, visual analogue pain score, and hospitalization periods were similar between the 2 techniques. Among 53 specimens obtained with laparoscopic stripping, 29 (55%) had no ovarian tissue, and 24 (45%) had ovarian tissue with follicles. Of 36 specimens obtained with extracorporeal technique, 19 (52%) had no ovarian tissue, and 17 (48%) had ovarian tissue with follicles. Preservation of the ovarian tissue was not significantly different between both surgical techniques.


CONCLUSIONS
Extracorporeal technique with laparoscopically-assisted minilaparotomy is a valuable alternative for laparoscopic stripping in selected cases.
Ceyhan
Temel
T
Department of Obstetrics and Gynaecology, Gulhane Military Medical Academy and Medical School, Ankara, Istanbul, Turkey. stceyhan@gata.edu.tr
Atay
Vedat
V
Gungor
Sadettin
S
Karateke
Ates
A
Oral
Ozay
O
Baser
Iskender
I
D000328:Adult; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010048:Ovarian Cysts / Q000175:diagnosis / Q000601:surgery*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome