title: Ovarian damage due to cyst removal: a comparison of endometriomas and dermoid cysts.
abstract: BACKGROUND
  Surgical treatment of endometriomas and potential damage to the ovary have been debated. Studies have described the inconsistent risk of unintended removal of ovarian tissue when a cystectomy of an endometrioma is performed. We evaluated the risk of inadvertently removed ovarian tissue during surgery by comparing specimens of endometriomas and dermoid cysts removed laparoscopically.
  
  
  METHODS
  The material included 326 women in a retrospective cohort study at Rigshospitalet, University hospital in Copenhagen, Denmark from 2011 to 2013. Surgery was performed laparoscopically for 393 benign cysts with a diagnosis of either endometrioma (n = 294) or dermoid cyst (n = 99). The microscopic existence of ovarian tissue in the cystectomy specimens were compared and correlation between CA 125 and size of cysts was examined.
  
  
  RESULTS
  In total, 80.3% endometrioma cystectomies disclosed ovarian stroma compared with 17.2% of the resected dermoid cysts (p < 0.001). The difference was found despite skilled laparoscopic surgeons performing the procedure in the endometriosis cohort. A significant positive correlation between the size of endometriomas and the value of CA 125 was found (p < 0.009).
  
  
  CONCLUSIONS
  The risk of removal of ovarian tissue during laparoscopic surgery is significantly higher for endometriomas than for dermoid cysts.
authors.affiliation: Department of Gynecology 4232, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Signe
authors.identifier: http://orcid.org/0000-0001-7148-9825
authors.initials: S
authors.lastname: Perlman
authors.affiliation: Department of Gynecology 4232, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens J
authors.identifier: http://orcid.org/0000-0002-3904-5201
authors.initials: JJ
authors.lastname: Kjer
mesh_terms: D000293:Adolescent; D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D003884:Dermoid Cyst / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D004715:Endometriosis / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D010053:Ovary / Q000293:injuries* / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D018394:CA-125 Antigen
keywords: CA 125; Endometrioma; dermoid cyst; laparoscopy; ovarian tissue; size of cyst