Laparoscopic treatment of adnexal cystic masses

Riccardo Marana, Stefania Ferrari, A Scarpa, L. Muzii

Risultato della ricerca: Contributo in rivistaArticolo in rivista

5 Citazioni (Scopus)

Abstract

Operative laparoscopy has become the gold standard for the surgical treatment of numerous gynecological benign conditions. In the case of ovarian cysts, however, the use of the laparoscopic approach has been debated due to the possibility of encountering an unexpected ovarian malignancy at the time of surgery. This would upstage a IA or IB ovarian malignancy to IC. In this review, the authors evaluate the preoperative parameters that could help in the selection of the patients who are candidate to a laparoscopic approach. In particular, the authors consider the age related risk of the patients, the use of sonography and color-Doppler velocimetry, the use of CA 125, and as a last diagnostic step, the findings at laparoscopy. In a personal series of 1 584 cysts hi patients under 40 years of age, the first author encountered 7 unexpected borderline tumors and 1 mucinous G1 adenocarcinoma, while no malignancy was found in a group of strictly selected postmenopausal patients. These data have been compared with those found in scientific literature. There is no sound evidence that the stripping procedure determines a reduction of the ovarian reserve when performed with strict microsurgical principles. Recent evidence in the literature suggests that the decreased ovarian responsiveness reported by some authors following ovarian cystectomy may not be a consequence of surgery. The concern of a possible reduction of the ovarian reserve needs to be balanced with the benefits obtained with surgery. Finally, it should always be kept in mind the risk of an unexpected malignancy, even in cysts apparently benign, malignancy that can only be diagnosed through surgery obtaining a specimen for pathology.
Lingua originaleEnglish
pagine (da-a)371-380
Numero di pagine10
RivistaMinerva Ginecologica
Volume58
Stato di pubblicazionePubblicato - 2006

Keywords

  • CA 125 antigen, adnexa disease
  • Gynecologic Surgical Procedures
  • Humans
  • Ovarian Cysts
  • cancer staging
  • color ultrasound flowmetry
  • cystadenocarcinoma
  • cystectomy
  • echography
  • gold standard
  • human
  • intraoperative period
  • laparoscopic surgery
  • medical literature
  • microsurgery
  • ovary cyst
  • postmenopause
  • preoperative evaluation
  • review
  • risk factor, Female

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