ABSTRACT
Benign ovarian cysts can be diagnosed and treated by surgical laparoscopy which, like laparotomy, permits a histological examination. Ovarian cysts that are, or are suspected of being malignant must be removed by laparotomy after evaluation by ultrasounds and diagnostic laparoscopy. Several techniques are used in laparotomic surgery, such as transparietal or intraperitoneal cystectomy ovariectomy, etc. Their indications vary according to the histology of the cyst and the operator's experience. From a series of more than 650 ovarian cysts treated by this method, we draw the following conclusions: the positive predictive value of this method concerning the benignity of the cyst was 100%; 89 to 97% of the cysts treated by laparoscopy were benign; complications occurred in only 3 out of 652 patients; except when endometriosis was present, the risk of recurrence was low: a second treatment was necessary in 2.7% of the cases.
Subject(s)
Laparoscopy/methods , Ovarian Cysts/diagnosis , Ovarian Cysts/surgery , Female , Humans , Laparoscopy/statistics & numerical data , Ovarian Cysts/epidemiology , RecurrenceSubject(s)
Brain Neoplasms/secondary , Cystadenocarcinoma, Serous/secondary , Ovarian Neoplasms/pathology , Brain Neoplasms/diagnosis , Brain Neoplasms/therapy , Combined Modality Therapy , Cystadenocarcinoma, Serous/diagnosis , Cystadenocarcinoma, Serous/therapy , Female , Humans , Middle Aged , Prognosis , Survival AnalysisABSTRACT
Laparoscopic management of annexes is now accepted as alternative to classical management by laparotomy. However, a careful pre-operative evaluation, including clinical and ultrasonographic examination is of ut most importance in order to exclude malignant lesion which should be treated by laparotomy. The laparoscopic treatment includes several procedures: intra-peritoneal cystectomy, extra-abdominal cystectomy, oaphorectomy and adnexectomy. These procedures and used according to the laparoscopic diagnosis. About 652 cases managed by laparoscopy, we can concluded: laparoscopic diagnosis of benign lesion is reliable (positive predictive value 100%); most of benign ovarian cysts can be treated by laparoscopy, from 89 to 97% of the benign adnexal cysts; complications are uncommon (8 cases out of 616 patients); the recurrence risk appears to be low (only 2.7% in patients treated for a non endometriotic adnexal cysts).