Management of ovarian dermoid cysts by laparoscopy compared with laparotomy.
Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 +/- 43.7 min, mean +/- SD) than those for the same procedures performed by laparotomy (73.9 +/- 21.6 min, p < 0.01), we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01). At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 +/- 1.7 ml versus 105.9 +/- 84.3 ml, p < 0.01) and shorter hospital stay (5.9 +/- 1.9 days versus 12.0 +/- 2.9 days, p < 0.01) were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.
Liyi
P
P
Department of Obstetrics and Gynecology The Jikei University School of Medicine 3-25-8 Nishi-shinbashi Minato-ku Tokyo 105 Japan.
Sasaki
H
H
Qing
L C
LC
Akiyama
M
M
Watanabe
A
A
Niimi
S
S
Tanaka
T
T