Is tumor size the limiting factor in a laparoscopic management for large ovarian cysts?

• Published in: Archives of gynecology and obstetrics Vol. 286; no. 5; pp. 1227 - 1232
• Main Authors: Lim, Soyi, Lee, Kwang-Beom, Chon, Seung-Ju, Park, Chan-Yong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-11-2012; Springer Nature B.V
• Subjects: Adenocarcinoma, Mucinous - drug therapy; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adolescent; Adult; Aged; Analysis of Variance; Blood Loss, Surgical; Carcinoma, Ovarian Epithelial; Cysts; Endocrinology; Female; General Gynecology; Gynecology; Human Genetics; Humans; Hysterectomy; Laparoscopy; Laparoscopy - adverse effects; Length of Stay; Medicine; Medicine & Public Health; Middle Aged; Neoplasms, Glandular and Epithelial - drug therapy; Neoplasms, Glandular and Epithelial - pathology; Neoplasms, Glandular and Epithelial - surgery; Obstetrics/Perinatology/Midwifery; Operative Time; Ovarian cancer; Ovarian Cysts - pathology; Ovarian Cysts - surgery; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovariectomy; Patients; Retrospective Studies; Salpingectomy; Tissue Adhesions - surgery; Tumor Burden; Young Adult; Ovarian cyst; Complication; Laparoscopy; Tumor size
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-012-2445-9

Purpose
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.
Conclusion
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.