title: Study of the correlation between tumor size and cyst rupture in laparotomy and laparoscopy for benign ovarian tumor: is 10 cm the limit for laparoscopy?
abstract: OBJECTIVE
  Laparoscopy is the gold standard for treatment of benign ovarian cysts, although there is a risk of intraoperative cyst rupture if the lesion is cancerous. This study is aimed at comparing the incidence of cyst rupture to tumor size in both laparotomy and laparoscopy in order to select the optimum surgical procedure for ovarian cysts.
  
  
  METHODS
  A total of 1483 cases of benign ovarian cysts were surgically treated at our center between 1995 and 2010. These cases were divided into three groups according to the maximum diameter of the ovarian tumors: <5 cm, ≥5 cm but <10 cm, and ≥10 cm. The incidence of cyst rupture was compared between laparotomy and laparoscopy according to the size of the tumor in ovarian tumorectomy and adnexectomy.
  
  
  RESULTS
  The incidence of cyst rupture was significantly higher in ovarian tumorectomy by laparoscopy than by laparotomy. Cyst rupture occurred independent of the tumor size in both laparoscopy and laparotomy. For adnexectomy for tumors smaller than 10 cm, there was no significant difference by tumor size in the incidence of cyst rupture between laparoscopy and laparotomy; however, the incidence of cyst rupture was significantly higher in laparoscopy of tumors sized 10 cm or larger than in the laparotomy of tumors of similar size; the incidence was also greater than laparoscopy of tumors smaller than 10 cm.
  
  
  CONCLUSIONS
  Laparotomy, rather than laparoscopy, is recommended in cases of ovarian cysts with any finding suggestive of malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan. shiota@med.kindai.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Shiota
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kotani
authors.forename: Masahiko
authors.initials: M
authors.lastname: Umemoto
authors.forename: Takako
authors.initials: T
authors.lastname: Tobiume
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hoshiai
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D010048:Ovarian Cysts / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D012421:Rupture / Q000453:epidemiology / Q000209:etiology