J Gynecol Oncol.  2011 Mar;22(1):18-24. 10.3802/jgo.2011.22.1.18.

Differences in perioperative outcomes after laparoscopic management of benign and malignant adnexal masses

Affiliations
  • 1Faculty of Medicine, El Menoufiya University, Shipin El Kom, Egypt.
  • 2Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA. herb.gretz@mssm.edu
  • 3St. Luke's-Roosevelt Hospital Center, New York, NY, USA.

Abstract


OBJECTIVE
To compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy.
METHODS
Retrospective study of 694 women that underwent laparoscopic management of an adnexal mass.
RESULTS
Laparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups.
CONCLUSION
Laparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.

Keyword

Laparoscopy; Benign; Malignant; Borderline; Adnexal mass

MeSH Terms

Female
Humans
Incidence
Intraoperative Complications
Laparoscopy
Laparotomy
Length of Stay
Operative Time
Ovarian Cysts
Ovarian Neoplasms
Postoperative Complications
Retrospective Studies
Rupture
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