The Possibility of Laparoscopic Cystectomy for Large Ovarian Dermoid Cyst in Young Age

Abstract

Study Object: To evaluate the possibility of laparoscopic cystectomy for large ovarian dermoid cyst in young age. Laparotomy usually has been performed for it due to small abdomen and spillage. Materials and Methods: The patients below 15 years-old were 33 of 71 patients. Large cyst (above 6 cm) were 15 of 33 patients. Intervention: The cysts classified to type A and type B according to contents. Type A has more fluid content than thick non-fluid content, and type B is opposite. In type A, cystectomy was modified to minimize the spillage of content by aspiration and suture before dissection of cyst and by immediate suction with suture for rupture. In below 15 years-old, Type A was 27 of 33 patients (81.8%) compared to 5 of 38 (13.2%) in older age (p<0.01). Results: In type A cysts during the operation, no rupture was 28 of 32 patients (87.5%) and ruptures but no spillage to abdomen were 4 (12.5%) and spillage case was none. However, in type B (p<0.05), no rupture was 23 of 39 (58.2%) and rupture but no spillage was 13 of 34.2 (34.2%) and the spillage was 3 of 39 (7.6%). In patients below 15 years-old, all 15 patients with cysts above 6 cm were type A compared to 12 of 18 (66.7%) with the smaller cysts (p<0.01). The spillage rates in below 16 years-old were no rupture 1 of 33 (3.0%), ruptures but no spillage 3 of 33 (88%) compared to in 38 older age patients (12.6%, 34.4% and 53%; p<0.05). Conclusions: Large dermoid cysts in young age has more fluid contents and modified operation to minimize spillage can be possible. Therefore, even in large dermoid cyst of young age, laparoscopic cystectomy is possible and sometimes easier than old age.