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

Lee, S Y; Oh, S T

Abstract

OBJECTIVES
To evaluate the possibility of modified laparoscopic cystectomy for large ovarian dermoid cyst in young age. Laparotomic cystectomy has been widely used for large ovarian benign dermoid cyst in young women, because they have relatively small pelvic cavities and spillage of content was often and the complete removal of spilled material in pelvic cavity was difficult.
METHODS
The success rate of modified laparoscopic cystectomy was analyzed in 71 patients who were diagnosed to benign dermoid cyst at the Department of Obstetrics and Gynecology, Chonnam University Hospital. Among 71 patients below 15 years old were 33 and the patients with large cysts[above 6 cm] were 15 of 33 patients. We classified cysts according to contents of cyst. Type A cyst has much fluidy contents[> or =50%] and Type B cyst has much solid contents[> or =50%]. We performed modified laparoscopic cystectomies. In Type A cysts, after the aspiration of contents and puncture site was sutured, cyst wall was stripped from the ovaries and removed by endopouch. In Type B cysts, after ovarian serosa was incised by needle bovie without aspiration of contents, cyst wall was stripped from ovary and removed by endopouch.
RESULTS
1. In below 15 years old, Type A cyst was 27 of 33 [81.8%] compared to 5 of 38 [13.2%] in older age[p<0.01] and all 15 patients[100%] with cysts above 6cm were Type A compared to 12 of 18 [66.7%] with below 6cm[p<0.01]. 2. With this modified method, in Type A cysts during operation, no rupture was 28 of 32[87.5%] patients and in Type B cysts, no rupture was 23 of 39[58.2%] patients[p<0.05].
CONCLUSIONS
Even in large ovarian dermoid cyst of young age, laparoscopic cystectomy is easily possible and easier than old age in occasion. It`s because of dermoid cysts in young age has more fluid contents than old age, so size of cyst can be decreased by aspiration and spillage can be minimize by suture.