title: Differences in perioperative outcomes after laparoscopic management of benign and malignant adnexal masses.
abstract: OBJECTIVE
  To compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy.
  
  
  METHODS
  Retrospective study of 694 women that underwent laparoscopic management of an adnexal mass.
  
  
  RESULTS
  Laparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups.
  
  
  CONCLUSIONS
  Laparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.
authors: Faculty of Medicine, El Menoufiya University, Shipin El Kom, Egypt.
authors: Mohamad S
authors: MS
authors: Gad
authors: Nabih I
authors: NI
authors: El Khouly
authors: Enrique
authors: E
authors: Soto
authors: Michael
authors: M
authors: Brodman
authors: Linus
authors: L
authors: Chuang
authors: Farr R
authors: FR
authors: Nezhat
authors: Herbert F
authors: HF
authors: Gretz
references: Surg Laparosc Endosc. 1996 Feb;6(1):38-45
references: 8808559
references: Eur J Cancer. 1995;31A(5):803-5
references: 7640058
references: Int J Gynecol Cancer. 2008 Nov-Dec;18(6):1202-9
references: 18284455
references: Am J Obstet Gynecol. 1996 Dec;175(6):1451-7; discussion 1457-9
references: 8987924
references: Clin Obstet Gynecol. 2001 Sep;44(3):495-521
references: 11685875
references: Am J Obstet Gynecol. 2005 Nov;193(5):1645-9
references: 16260204
references: Bull Acad Natl Med. 2007 Oct;191(7):1357-65; discussion 1365-6
references: 18447057
references: Am J Obstet Gynecol. 2009 Jan;200(1):83.e1-6
references: 19019337
references: Ann Oncol. 2005 Mar;16(3):403-10
references: 15653700
references: Ann N Y Acad Sci. 2006 Dec;1092:211-28
references: 17308146
references: Obstet Gynecol. 1999 Feb;93(2):223-8
references: 9932560
references: Chin Med J (Engl). 2006 Feb 5;119(3):202-6
references: 16537005
references: JSLS. 2004 Apr-Jun;8(2):133-9
references: 15119657
references: Obstet Gynecol. 2003 Aug;102(2):243-51
references: 12907095
references: Gynecol Oncol. 2007 May;105(2):409-13
references: 17275077
references: Int J Gynecol Cancer. 1994 Sep;4(5):333-336
references: 11578428
references: Med J Armed Forces India. 2004 Jan;60(1):28-30
references: 27407573
references: Am J Obstet Gynecol. 2005 May;192(5):1614-9
references: 15902166
references: Clin Obstet Gynecol. 2006 Sep;49(3):535-48
references: 16885660
references: Gynecol Oncol. 2003 Oct;91(1):179-89
references: 14529679
references: Eur J Obstet Gynecol Reprod Biol. 1994 Sep;56(3):177-80
references: 7821490
references: J Gynecol Surg. 1995 Fall;11(3):153-8
references: 10172733
references: Lancet. 2001 Jan 20;357(9251):176-82
references: 11213094
references: J Minim Invasive Gynecol. 2009 May-Jun;16(3):250-62
references: 19321390