Management Of Benign Ovarian Cysts Research Articles

Study protocol for a randomised controlled trial on the use of intraoperative ultrasound-guided laparoscopic ovarian cystectomy (UGLOC) as a method of fertility preservation in the management of benign ovarian cysts

IntroductionThe lifetime risk of women undergoing surgery for the presence of benign ovarian pathology in the UK is 5%–10%. Despite minimally invasive surgical techniques, evidence suggests a number of healthy...

Laparoscopic Management of Benign Ovarian Cysts: Three Years Experience in Combined Military Hospital, Dhaka

Introduction: Ovarian cyst is a common clinical problem affecting women of all age groups. Laparoscopy should be considered as an alternative to laparotomy in the management of benign ovarian cysts. The aim of this study is to determine the safety, efficacy and outcome of laparoscopic surgery for benign ovarian cysts.
 Materials and Method: A Prospective observational study has been carried out during the period of Jun 2016 to May 2019 in combined military hospital Dhaka. Total 107 patients who underwent laparoscopic surgery for benign ovarian cysts during this period were included in this study.
 Results: The maximum number of women was in the 21-30 year- old age groups. Majority were endometriotic cyst (45.79%) followed by perovarian cysts (14.01%) and dermoid cysts (12.14%). The diameter ranges from 4-15 cm.and most of them were unilateral (91.5%). Ovarian cystectomy is the most commonly performed procedure (88.78%). Mean duration of surgery was 62.75 minutes. Complications were also fewer like postoperative fever (22.2%), and trocar site infection.(11.2 %). None of the pts required conversion to laparotomy.
 Conclusion: With a careful preoperative screening the laparoscopic surgery is a safe and effective treatment for benign ovarian cyst Laparoscopic surgery seems to offer significant advantages such as less adverse effects, reduced hospital stay and better quality of life.
 JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 209-2012

Benefits, Drawbacks and Precautions of Performing Laparoscopy and Laparotomy in Management of Benign Adnexal Masses in Pregnant Women; A Comparative Study

Surgical management strategies of benign ovarian cysts diagnosed during pregnancy include cyst resection, ovarian excision, or salpingo-oophrectomy but the best surgical procedure is still controversial. Using laparoscopic assisted methods has been extensively used in management of many gynecologic related diseases in non-pregnant women. Previously, performing laparoscopic surgeries for management of benign ovarian cysts during pregnancy was limited to only case reports, case series and retrospective studies. Aim of the study was to compare between laparoscopic and conventional open surgery for management of benign adnexal cysts in pregnant women, regarding; pregnancy outcome, benefits and drawbacks on mother and fetus, operative and perioperative details. Patients and methods We included 80 pregnant females with benign ovarian cysts who were eligible for the study, splitting them in to 2 cohorts each group contain 40 patients the first cohort underwent laparoscopic excision of the ovarian cyst and the second cohort underwent conventional laparotomy for management of the ovarian cysts. Results We found statistically significant differences between both studied groups regarding the overall costs of the operation as; anesthesia, surgery, and materials costs and in comparison with laparotomy, the laparoscopy related costs associated were higher (p < 0.001). We found that duration of post-operative hospital staying was shorter in laparoscopy group than laparotomy group (p < 0.001). The rate and duration of antibiotic prophylaxis was lower in laparoscopy group than laparotomy group (p < 0.001). The rate of wound healing was higher in the laparoscopy group. The postoperative fever rate and degree of maximum temperature was less in laparoscopy group than laparotomy group (p = 0.005). Conclusion We concluded that performing laparoscopic assisted surgical procedure for excision of benign ovarian cystic masses in pregnant women lead to less blood loss, shorter hospitalization better wound healing with no increased risks of fetal or maternal complications than laparotomy. Although laparoscopy has higher costs but it was more accepted by the patients as it is minimally invasive.

Benefits, Drawbacks and Precautions of Performing Laparoscopy and Laparotomy in Management of Benign Adnexal Masses in Pregnant Women; A Comparative Study

Surgical management strategies of benign ovarian cysts diagnosed during pregnancy include cyst resection, ovarian excision, or salpingo-oophrectomy but the best surgical procedure is still controversial. Using laparoscopic assisted methods has been extensively used in management of many gynecologic related diseases in non-pregnant women. Previously, performing laparoscopic surgeries for management of benign ovarian cysts during pregnancy was limited to only case reports, case series and retrospective studies. Aim of the study was to compare between laparoscopic and conventional open surgery for management of benign adnexal cysts in pregnant women, regarding; pregnancy outcome, benefits and drawbacks on mother and fetus, operative and perioperative details. Patients and methods We included 80 pregnant females with benign ovarian cysts who were eligible for the study, splitting them in to 2 cohorts each group contain 40 patients the first cohort underwent laparoscopic excision of the ovarian cyst and the second cohort underwent conventional laparotomy for management of the ovarian cysts. Results We found statistically significant differences between both studied groups regarding the overall costs of the operation as; anesthesia, surgery, and materials costs and in comparison with laparotomy, the laparoscopy related costs associated were higher (p < 0.001). We found that duration of post-operative hospital staying was shorter in laparoscopy group than laparotomy group (p < 0.001). The rate and duration of antibiotic prophylaxis was lower in laparoscopy group than laparotomy group (p < 0.001). The rate of wound healing was higher in the laparoscopy group. The postoperative fever rate and degree of maximum temperature was less in laparoscopy group than laparotomy group (p = 0.005). Conclusion We concluded that performing laparoscopic assisted surgical procedure for excision of benign ovarian cystic masses in pregnant women lead to less blood loss, shorter hospitalization better wound healing with no increased risks of fetal or maternal complications than laparotomy. Although laparoscopy has higher costs but it was more accepted by the patients as it is minimally invasive.

Management of benign ovarian cysts in a semiurban hospital: a retrospective study

Background: Benign ovarian cysts are one of the most common cause of surgery. Most of these cysts are asymptomatic and are accidentally found when undergoing a pelvic examination. We conducted a study on the types of benign ovarian cysts in our setup and their surgical management.Methods: 156 patients who were clinically diagnosed and operated on benign ovarian cysts were included into the study. Transvaginal ultrasound was performed in all the patients to assess the size of cysts and other characteristics of the mass and to exclude malignancy. All the cysts were laparoscopically treated.Results: Out of 156 patients, most of the patients (27.9%) had come to the hospital with chronic pelvic pain. 25.3% of the patients were asymptomatic and 14.3% had complaints of pelvic mass. Endometrioma which was seen in more than 50% of the cases followed by dermoid cysts seen in 24.3% of the cases. The most common type of surgery performed on the patients was cystectomy in 85.3% followed by oophorectomy in 10.9% of the cases and in 3.8%, a complete laparoscopic salpingo-oophorectomy was performed. Complications was observed in 1.3% of the cases.Conclusions: Laparoscopic surgery for the removal of benign ovarian cysts the most preferred type of surgery, with cystectomy being the most common type and that with salpingo-oophorectomy being fairly uncommon. As, this is not without complications, careful patient selection and proper surgical experience is required o ensure a safe laparoscopy.

Laparoscopic Management of Large Benign Ovarian Cysts

Background: Laparoscopy is a valid surgical technique for the management of benign ovarian cysts. But its effectiveness when dealing with large cysts is unclear. Our aim is to evaluate the results of laparoscopy in routine management of huge benign ovarian cysts. Materials and Methods: We performed a prospective study from August 2014 to January 2016. We enrolled 42 patients with large benign ovarian cysts laparoscopically managed in the department of Gynecology and Obstetrics at Charles Nicolle’s hospital. Results: Eight patients had emergency laparoscopy for suspected adnexal torsion. The laparoscopic exploration revealed a right ovary cyst in 63% of cases and a left ovarian cyst in 35% of patients without any extra-cystic vegetation. A cystectomy was performed in 42% and an adnexectomy in all the other cases. A bilateral adnexectomy was performed in 25% of cases. A laparoconversion was needed in 32.7% of cases. No vascular, digestive or infectious complications were observed. The mean duration of the operative procedure was 115 minutes. The average hospital stay was 3 days. Pathological examination of the surgical specimens revealed a serous cystadenoma in 33 cases. Conclusion: Laparoscopy is a safe and reliable first choice in the management of huge benign ovarian cysts.

Management of benign ovarian cysts by a novel, gasless, single-incision laparoscopic technique: keyless abdominal rope-lifting surgery (KARS)

To find the most efficacious method to minimize the side effects and maximize the advantages of laparoscopic surgery, this study aimed to define and document a gasless, single-incision abdominal access technique for the management of benign ovarian cysts. During a 1½ year period, 55 women underwent surgery for a benign ovarian cyst. Conventional carbon dioxide (CO(2)) laparoscopy was used for 33 of the women, and 22 of the women underwent a novel, gasless, single-incision laparoscopic surgery. An abdominal access pathway through a single intraabdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intra-umbilical entry without the use of trocars. Thus, the new technique was called keyless abdominal rope-lifting surgery (KARS). Two operative groups were compared to assess the feasibility of the new technique. All the operations could be performed by KARS without conversion to CO(2) laparoscopy or laparotomy. However, for two patients in the conventional laparoscopy group, minilaparotomy had to be performed for tissue retrieval. Although the two techniques had many similar results, the total operative times and the abdominal access times in the KARS group were significantly longer than in the conventional laparoscopy group (p < 0.05). Simple oral analgesics were adequate for postoperative pain relief in both groups. The KARS technique is a gasless, single-incision laparoscopic procedure that can be performed safely and effectively in terms of cosmesis, postoperative pain, and fertility preservation for the management of benign adnexal pathologies.

Percutaneous Drainage without Sclerotherapy for Benign Ovarian Cysts

To evaluate percutaneous short-term catheter drainage in the management of benign ovarian cysts in patients at increased surgical risk. Thirty-eight patients with simple ovarian cysts were treated with drainage of fluid content by catheters until output stopped. All patients were poor candidates for surgery. All procedures were performed under ultrasonographic (US) control and local anesthesia. Cytologic examination was performed in all cases. The patients were followed up monthly with color Doppler US for 12 months. Outcome measure was the recurrence of a cyst. During the 12-month follow-up period, 10 of 38 cysts recurred. Seven of the 10 cysts required further intervention, and three were followed up without intervention. Four of the seven patients who required further intervention underwent repeat transabdominal aspiration and three declined repeat aspiration and subsequently underwent surgery. After repeated aspirations, two of four cysts disappeared, one necessitated follow-up only, and one necessitated surgical intervention. Cyst volume (P = .009) and diameter (P = .001) were significantly larger in the cysts that recurred. No evidence of malignancy was reported in the cytologic examination in any patient. No patients developed malignancy during follow-up. No major complications were observed. The hospital stay was 1 day for all patients. The median duration of drainage in the groups with resolved and recurrent cysts was 1 day (interquartile range, 1-1) and 2 days (interquartile range, 1-3), respectively (P = .04). In patients considered poor candidates for open surgery or laparoscopy, percutaneous treatment of ovarian cysts with short-term catheter drainage without sclerotherapy appears to be a safe and effective alternative, with low recurrence rates.

The safety of laparoscopic treatment for ovarian dermoid tumours.

Whilst laparoscopic surgery has largely replaced laparotomy as the standard surgical option for the management of benign ovarian cysts, concern remains regarding the safety of laparoscopy for benign cystic teratomas. This is based on a higher rate of cyst content spillage compared to laparotomy and the known sequelae of chemical peritonitis and granuloma formation. We present 18 cases of laparoscopic dermoid cystectomy with recommendations for specimen removal from the peritoneal cavity. Our findings together with evidence from the literature confirms the safety of laparoscopy for the treatment of ovarian dermoid cysts.

Laparoscopic Ovarian Cystectomy Inside a Bag: A New Operative Technique for Dermoid Cysts

The laparoscopic approach has been shown to be safe for management of benign ovarian cysts. Dermoid cysts have up to 2% incidence of malignancy, which cannot be diagnosed preoperatively. They usually occur in women of reproductive age who wish to conserve ovarian tissue, and, therefore, conservative surgery is indicated. The main concerns of laparoscopic cystectomy for dermoids is spillage of cyst contents, which could theoretically cause chemical peritonitis or malignant spread. We describe a laparoscopic technique for ovarian cystectomy inside a bag that avoids the risk of spillage of cyst contents. (J GYNECOL SURG 13:35, 1997)