Management of cystic ovarian masses by laparoscopic surgery: results of 275 cases

Abstract

Objective To assess the results of operative laparoscopy in terms of operation time, postoperative care, histological diagnosis and complications. Design Retrospective evaluation of women who had undergone laparoscopic management of cystic ovarian masses. Setting Two Swedish university hospitals. Subjects 275 women with clinically and sonographically benign cystic ovarian masses. Interventions Operative laparoscopy under general anaesthesia was carried out in all the women. Bipolar coagulation, suture loops, suction/irrigation and various cutting instruments were used. Main outcome measures and Results No major intraoperative complications occurred in this series. Minor complications included injury of the inferior epigastric artery, postoperative nausea, shoulder pain and temporary urine retention. Three patients underwent a second surgical procedure because of postoperative intra-abdominal bleeding. The adnexal cystic masses varied in size from 2 to 12 cm (mean 5.5 cm). The mean total operation time was 54 min (range 15–200 min). The postoperative stay at the clinic ranged from 6 to 144 h (mean 23 h). Histopathological examination showed malignancy in 1.8% of the cases. Conclusions In this setting operative laparoscopy appears to be a safe and effective method for treating clinically and ultrasonographically benign ovarian cysts. Day surgery is possible in the majority of cases.