A Case of laparoscopic surgery for huge dermoid cyst / 대한산부인과학회잡지

Dermoid cysts are the most common type of ovarian neoplasms occurring during a woman's reproductive life and account for 25% of all premenopausal ovarian neoplasms. Intraoperative spillage of dermoid cyst materials may lead to febrile morbidity, ileus, peritonitis, adhesion or fistula formation. Rarely, malignant element spillage, if present, may also lead to cancer dissemination. The management of dermoid cyst is controversal. Recently, laparoscopic surgery for ovarian cysts has been increasingly accepted. But, in view of the high risk of intraperitoneal rupture of large sized cysts, many surgeon still prefer the laparotomic approach. Recently, we did laparoscopic salphingo-oophorectomy to the patient having 20cm sized dermoid cyst. Intraoperative spillage of cyst material occurred, but patient recovered without any postoperative complication. So, we present this case with brief review of the literatures.

A Comparative Study of Laparoscopy and Laparotomy for the Management of Ovarian Dermoid Cyst / 대한산부인과학회잡지

OBJECTIVE: The objective of this study was to compare laparoscopic surgery with laparotomy for surgical management of ovarian dermoid cysts. METHODS: One hundred and fifteen patients were managed with laparoscopy and eighty two patients were managed with laparotomy. Two groups were compaired for age, marrital status, parity, tumor size, operation type, previous surgery, operating time, blood loss, pre-, and postoperative hemoglobin change, hospital stay, complications and recurrences. RESULTS: Unilateral slapingo-oophorectomy was the most common type of operation in either group. Between twenty one and thirty was the most common age in either group and para 0 in laparoscopy and para 2 in laparotomy group was the most common. Unilateral ovarian cystectomy was significantly more common for para 0 in laparoscopy group (p=0.035). Number of singles were significantly higher in laparoscopy group (p=0.046). Tumor size was significantly larger in laparotomy group (6.1 vs 7.8 cm). Operating time was shorter for unilateral ovarian cystectomy in laparoscopy group. Blood loss, pre-, and postoperative hemoglobin change, hospital stay was significantly less in laparoscopy group. Febrile morbidity was higher in laparotomy group (p<0.001). However no major complications were noted in either group. CONCLUSION: We conclude that operative laparoscopy has many advantages in the management of ovarian dermoid cysts. However tumor size was a relative limitations for laparoscopy compaired with laparotomy.