Is tumor size the limiting factor in a laparoscopic management for large ovarian cysts?
OBJECTIVE
To assess the feasibility and short-term surgical outcome of laparoscopic surgery among women with large ovarian cysts.


METHODS
We retrospectively evaluated consecutive 81 patients who received laparoscopic management for ovarian cysts with diameter ≥ 10 cm and without radiologic features suggestive of malignancy, from March 2008 to September 2011.


RESULTS
Laparoscopic surgery was successful in 77 (95.1 %) of the total patients. The mean (range) operative time, estimated blood loss (EBL) and hospital stay were 107.6 (55-250 min), 226.9 (10-1300 mL) and 6.1 (4-15 days), respectively. The surgical procedures performed included salpingooophorectomy (SO) (n = 44), ovarian cystectomy (OC) (n = 22), adhesiolysis (n = 1), salpingectomy (n = 2) and total laparoscopic hysterectomy (TLH) with SO (n = 8). Conversion to laparotomy occurred with four patients. One patient had postoperative bleeding and one had minor complications associated with wound oozing at the umbilical port site. Histopathological examination revealed benign tumors in 76 patients (93.8 %), borderline ovarian tumor in three patients (3.7 %) and invasive epithelial ovarian cancer in two patients (2.5 %). Clinicopathological variables according to tumor size were not statistically different. Complications did not appear in any patients during the follow-up period.


CONCLUSIONS
With proper patient selection, laparoscopy is a feasible and safe treatment for women with large ovarian cysts and tumor size did not have effect on laparoscopic management. However, surgeons should carefully consider the potential risk of malignancy in such patients.
Department of Obstetrics and Gynecology, Gil Hospital, Gachon University of Medicine and Science, 1198 Guwol-dong, Namdong-gu, Incheon, Korea. soyilim@gmail.com
Soyi
S
Lim
Kwang-Beom
KB
Lee
Seung-Ju
SJ
Chon
Chan-Yong
CY
Park
D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016063:Blood Loss, Surgical; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D061646:Operative Time; D010048:Ovarian Cysts / Q000473:pathology* / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D012189:Retrospective Studies; D058994:Salpingectomy; D000267:Tissue Adhesions / Q000601:surgery; D047368:Tumor Burden; D055815:Young Adult