Experience of 26 Cases of Laparoscopic Surgery for Pedicle Torsion of Ovarian Cyst with Pregnancy / 中国微创外科杂志

ABSTRACT

Objective To investigate the experience of laparoscopic surgery for pedicle torsion of ovarian cyst with pregnancy. Methods A retrospective analysis was made on 26 cases of pregnancy complicated with pedicle torsion of ovarian cyst receiving emergency laparoscopic surgery from January 2009 to December 2016 in our hospital. After the establishment of pneumoperitoneum, laparoscopic cyst dissection or accessory resection of the affected side was performed according to intraoperative conditions. Patients with early pregnancy were given progesterone 20-40 mg intramuscular injection, once a day for 3 days. Patients with late pregnancy were given intravenous drip of magnesium sulfate, 5 g daily for 3 days. The pregnancy outcome was recorded by readmission records, outpatient visits, or telephone follow-ups. Results Laparoscopic surgery was performed in all the 26 patients. During operation, 11 patients with ovarian necrosis underwent affected side resection, and the remaining 15 patients underwent enucleation of the affected ovary. The operation time was 20-60 min (average, 47. 8 min). The intraoperative bleeding was 10-400 ml (average, 88. 8 ml). The hospitalization time was 2-16 d (average, 5. 8 d). There were 21 cases of postoperative tocolytic therapy (80. 8%). All the 26 patients had no symptoms of miscarriage or premature delivery. They continued to term delivery, including 13 cases of spontaneous labor and 13 cases of caesarean section. The newborns were healthy, with 1-and 5-min Apgar scores of 8-10 points. Conclusions It is safe to treat the pregnancy complicated with pedicle torsion of ovarian cyst by laparoscopic surgery. Surgery is difficult for large cysts and late pregnancy.