Briones-Landa CH, Ayala-Yáñez R, Leroy-López L, Anaya-Coeto H, Santarosa-Pérez MÁ, Reyes-Muñoz E

Language: Spanish
References: 12
Page: 527-532
PDF size: 228.33 Kb.

ABSTRACT

Background: Benign cystic teratoma is one of the most common benign tumors of the ovary, according to international series represents between 44 and 62% of all ovarian tumors diagnosed in women younger than 40 years.
Objectives: To evaluate and compare the efficacy and safety between laparoscopy and laparotomy in the management of ovarian teratomas, as well as the recurrence between both techniques.
Materials and method: Retrospective, clinical series study involving 169 cases of ovarian teratomas operated at the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes in the period comprehended between 2000-2008. The cases were divided into the ones solved by laparoscopy, corresponding to group 1 (102 cases) and 67 cases solved by laparotomy, corresponding to group 2.
Results: Group 1 (laparoscopic approach) consisted of 102 patients (60.3%), and group 2 (laparotomy approach) had 67 patients (39.7%). Surgical bleeding: 55.7 ± 21.4 mL vs. 91.6 ± 29.2 mL (p ‹ 0.0001), hospital stay: 1.6 ± 0.57 vs. 2.7 ± 0.42 days (p ‹ 0.0001), surgical time: 110.3 ± 27.2 vs. 83.6 ± 26.9 minutes (p ‹ 0.0001), teratoma size: 7.2 ± 2.3 vs. 11.5 ± 4.2 cm (p ‹ 0.0001) in groups 1 and 2, respectively. Teratoma rupture had 57.8% incidence (59 cases) in group 1, and 16.4% in group 2 (11 cases). Laparoscopy was a risk factor for broken open for ovarian cyst (OR: 6.9; CI 95%: 3.3-14.8). Not a single case was complicated by chemical peritonitis in any study group.
Conclusions: Laparoscopic approach to teratomas is a safe and efficient procedure, it does not increase complications in comparison to the laparotomy approach; it presents less bleeding and short hospital stay, offering a quick recovery.

REFERENCES

1. Templeman CL, Fallat ME, Lam AM, Perlman SE, et al. Managing mature cystic teratomas of the ovary. Obstet Gynecol Surv 2000;55:738-745.

2. Fondeur LV, García MI, Santarosa MA, Zaldívar A, Bustos HH. Características clínicas y abordaje quirúrgico del teratoma ovárico. Perinatol Reprod Hum 2001;219-228.

3. 3 Shawki O, Ramadan A, Askalany A, Bahnassi A. Potential fear of dermoid spill, myths and facts. Gynecol Surg 2007;4:255-260.

4. Shawki O, Soliman I, Ebrashy A, El Sadek M, Bahnassy A. Laparoscopic management of ovarian dermoid cysts. Middle East Fertil Society J 2004;9:58-65.

5. Sokalska A, Timmerman D, Testa AC, Van Holsbeke C, et al. Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses. Ultrasound Obstet Gynecol 2009;34:462-470.

6. Medeiros LR, Stein AT, Fachel J, Garry R, Furness S. Laparoscopy versus laparotomy for benign ovarian tumor: a systematic review and meta-analysis. Int J Gynecol Cancer 2008;18:387-399.

7. Management of adnexal masses. ACOG Practice Bulletin No. 83. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007;110:201-214.

8. Benezra V, Verma U, Wayne R. Comparison of laparoscopy versus laparotomy for the surgical treatment of ovarian dermoid cysts. Gynecol Surg 2005:89-92.

9. Chang CK, Teng SW, Leu FJ. Laparoscopy versus laparotomy for cystic ovarian teratomas. Int J Gynaecol Obstet 2005;88:69-70.

10. Savasi I, Lacy JA, Gerstle JT, Stephens D, et al. Management of ovarian dermoide cysts in the pediatric and adolescent population. J Pediatr Adolesc Gynecol 2009;22:360-364.

11. Medeiros LR, Rosa DD, Bozzetti MC, Fachel JM, et al. Laparoscopy versus laparotomy for benign ovarian tumour. Int J Gynecol Cancer 2008;18:387-399.

12. Laberge PY, Levesque S. Short-term morbidity and long-term recurrence rate of ovarian dermoide cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can 2006;28:789-793.