Résumé
OBJECTIVE: To evaluate the benefits of laparoscopic surgery compare with laparotomy in the surgical management of adnexal tumors during pregnancy. METHODS: Operating time, hospital stays, complications and pregnancy outcome were analyzed in 18 patients who underwent laparoscopic surgery and 30 patients who underwent laparotomy due to adnexal tumors discovered during pregnancy at Chungnam National University Hospital from January 1993 to June 2000. RESULTS: Mean age of the patients was 27.1 years and mean gestational age was not significantly different between the two groups. Tumor size was larger in laparotomy group (8.4 vs 6.4 cm in diameter). Unilateral salpingo-oophorectomy was most common operative procedures and cystic teratoma was most common histologic findings in both groups. Operating time was not significantly different between the two groups. Blood loss (43.2 vs 18.3 mL) and hospital stay (7.1 vs 5.7 days) was significantly less in laparscopy group. CONCLUSIONS: Laparoscopic surgery may be an effective treatment of adnexal tumors during pregnancy.
Sujets)
Femelle , Humains , Grossesse , Âge gestationnel , Laparoscopie , Laparotomie , Durée du séjour , Kystes de l'ovaire , Issue de la grossesse , Procédures de chirurgie opératoire , TératomeRésumé
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.
Sujets)
Femelle , Humains , Kyste dermoïde , Fistule , Iléus , Laparoscopie , Kystes de l'ovaire , Tumeurs de l'ovaire , Péritonite , Complications postopératoires , Rupture , TératomeRésumé
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.