The Comparison of Pelviscopic Cystectomy with Laparotomic Cystectomy for Dermoid Cyst over 6cm

Kim, E M; Lee, J Y; Oh, S T

Abstract

Traditionally laparotomic cystectomy has been performed for large ovarian dermoid cyst, because the spillage of content was inevitable and the complete removal of spilled material in pelvic cavity was difficult. Therefore the method of pelviscopic cystectomy was modified to minimize the spillage of content for dermoid cyst over 6 cm in our hospital. The purpose of this study is to evaluate the efficacy of this pelviscopic cystectomy compared with traditional laparotomic cystectomy. Dermoid cysts over 6 cm were diagnosed by ultrasonography, MRI, CT and diagnostic laparoscopy. The duration of operation, postoperative recovery time and duration of hospital stays in 45 patients treated by modified pelviscopic cystectomy were compared with those in 27 patients treated by laparotomic cystectomy. The mean duration of operations was 1.37 +/- 0.7 hours in laparotomy and 1.59 +/- 0.4 hours in pelviscopy, so any significant difference was not found between these two groups. Postoperative complication due to spillage of content was not noticed in either laparotomy or pelviscopy. Recovery of gastrointestinal peristalsis was observed at postoperative 1.9 +/- 0.8 days in laparotomy and 1.0 +/- 0.5 days in pelviscopy. Therefore peristalsis of gastrointestinal tract was more rapidly recovered in pelviscopy than in laparotomy (p<0.01). Dis-appearance of major postoperative pain was observed on 2.7 +/- 0.8 days after operation in laparotomy and 1.3 +/- 0.4 days in pelviscopy, so postoperative pain was disappeared more rapidly in pelviscopy (p<0.01). The mean duration of hospital stay was 4.2 +/- 0.4 days in pelviscopy, and it was significantly shorter than 5.5 +/- 0.7 days in laparotomy (p<0.01). Therefore it was suggested that pelviscopic cystectomy, if it is modified to minimize peritoneal spillage of contents, was better than laparotomy even in dermoid cyst over 6 cm.