A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses

Yuen, Pong Mo; Yu, K.M.; Yip, S. K. H.; Lau, Wan-yee; Rogers, Michael S.; Chang, Allan

doi:10.1016/s0002-9378(97)70447-2

Cited by 292 publications

(181 citation statements)

References 17 publications

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“…The American College of Obstetricians and Gynecologists Practice Bulletin suggests that the true recurrence rate must be even higher than the rate generally reported in literature, because most publications report symptomatic disease only [11]. Conservative laparoscopic surgery is considered to be the gold standard for the treatment of ovarian endometriosis [12][13][14][15][16][17]. There is general agreement that endometrioma removal increases the likelihood of conception [18,19], and recent evidence shows that both the presence of an endometrioma and its surgical excision may impair ovarian reserve and, therefore, future fertility [20,21], especially after a second operation.…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative longterm regimen of oral contraceptives (OCs). Materials and methods 168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.Results Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients. Conclusion The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.

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Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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“…According to other authors, intra-operational evacuation of the contents of the cyst into the peritoneal cavity rarely leads to complications [18][19][20].…”

Section: Discussionmentioning

confidence: 94%

Struma ovarii – a dermoid and serous form of ovarian cyst

Sikora-Szczęśniak¹,

Sikora²

2013

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Struma ovarii belongs to the class of monodermal and highly specialized teratomas. These tumors are detected mainly among mature teratomas, accounting for up to 3% of all ovarian teratomas. Besides dermoid cysts, thyroid tissue is also found in serous and mucous cysts within the ovary. The aim of the research was to analysis of the incidence of struma ovarii -a rare type of tumor -among dermoid and serous ovarian cysts. Medical documentation of female patients subjected to surgery in the Department of Gynecology and Obstetrics, Independent Public Health Care Institution in Lipsko over a period of 17 years was reviewed for cases of struma ovarii. Struma ovarii was detected in 4 out of 103 operated females with dermoid and serous cysts. Thyroid tissue and serous cyst with a double-twisted pedicle were detected in a 22-year-old patient in the 10 th week of gestation within the left ovary. In three cases of patients aged 42, 46, and 51, thyroid tissue encapsulated in dermoid cells was also located on the left side. All diagnoses were made on the basis of histopathological assessments. In a 17-year observation period, gestational struma ovarii was identified in one out of 17,751 patients whose pregnancies led to delivery. This accounts for 0.0068% of pregnancies ending with delivery. Struma ovarii was detected in one half of the patients in whom dermoid cells were detected bilaterally.

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“…Laparotomy is a treatment option that uses a Pfannenstiel or subumbilical midline incision. 17 An abdominal incision is performed to allow adequate intraoperative exposure. 18 In a 1996 article written by Yuen et al, 17 it was reported that laparoscopy was increasing in popularity in the management of benign ovarian masses.…”

Section: Discussionmentioning

confidence: 99%

“…17 An abdominal incision is performed to allow adequate intraoperative exposure. 18 In a 1996 article written by Yuen et al, 17 it was reported that laparoscopy was increasing in popularity in the management of benign ovarian masses. Benefits of laparoscopy include reductions in operative morbidity, hospital stay, and recovery time.…”

Section: Discussionmentioning

confidence: 99%

“…Worley et al 19 noted other benefits including faster recovery due to decreased analgesic requirements and a decreased time for return of bowel function. Complications of laparoscopy include tumor spillage during the operation in cases of a malignant ovarian tumor being misdiagnosed 17 ; vascular, bowel, and genitourinary injuries; incisional hernias; port-site metastases; and gas embolism. 19 …”

Section: Discussionmentioning

confidence: 99%

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A calcific pelvic mass in a woman with chronic spinal pain: a case of mature cystic teratoma

Kaeser

McDonald²,

Kettner

2011

Journal of Chiropractic Medicine

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Objective: The purpose of this case is to describe findings of a mature cystic teratoma and to further provide differential diagnoses for ovarian pelvic masses and calcifications. Clinical Features: A 27-year-old woman presented to a chiropractic teaching clinic with a chief complaint of chronic multilevel spinal pain. During a full spine radiographic examination, radiopaque densities were incidentally identified in the pelvic bowl visualized through a gonad shield. Follow-up pelvic radiography revealed several radiopacities of uniform density localized in the pelvic bowl. Intervention/Outcomes: Medical (gynecological) consultation led to ultrasonography of the pelvis that revealed a mature cystic teratoma. The patient underwent complete excision of the mass through a laparotomy procedure. The patient continued to receive chiropractic treatment of her original cervical and lumbar spine complaints, further suggesting that the pelvic mass was not a source of her musculoskeletal complaints. Conclusion: This case demonstrates the detection and proper referral of a patient with a calcific mass. The presence of a pelvic mass, suspected of arising from the ovary, requires additional diagnostic imaging and careful clinical correlation.

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A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses

Cited by 292 publications

References 17 publications

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Struma ovarii – a dermoid and serous form of ovarian cyst

A calcific pelvic mass in a woman with chronic spinal pain: a case of mature cystic teratoma

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