[Laparoscopy for diagnosis and treatment of adnexal masses].
نویسندگان
چکیده
PURPOSE To assess clinical factors, histopathologic diagnoses, operative time and differences in complication rates between women undergoing laparoscopy or laparotomy to diagnose and treat an adnexal mass and their association with laparoscopy failure. METHODS In this prospective study, 210 women were invited to participate and 133 of them were included. Eighty-eight women underwent laparotomy and 45 underwent laparoscopy. Fourteen of the 45 laparoscopies were converted to laparotomy intraoperatively. We assessed whether age, body mass index (BMI), previous abdominal surgeries, CA-125, Index of Risk of Malignancy (IRM), tumor diameter, histological diagnosis, operative time and surgical complication rates differed between the laparoscopy group and the group converted to laparotomy and whether those factors were associated with conversion of laparoscopy to laparotomy. We also assessed surgical logs to evaluate the reasons, as stated by the surgeons, to convert a laparoscopy to laparotomy. RESULTS In this research, 30% of the women had malignant tumors. CA-125, IRM, tumor diameter and operative times were higher for the laparotomy group than the laparoscopy group. Complication rates were similar for both groups and also for the successful laparoscopy and unsuccessful laparoscopy groups. The surgical complication rate in women with benign tumors was lower for the laparoscopy group than for the laparotomy group. The factors associated with conversion to laparotomy were tumor diameter and malignancy. During laparoscopy, adhesions a large tumor diameter were the principal causes of conversion. CONCLUSION This study suggests that laparoscopy for the diagnosis and treatment of adnexal masses is safe and does not increase complication rates even in patients who need conversion to laparotomy. However, when doubt about the safety of the procedure and about the presence of malignancy persists, consultation with an expert gynecology-oncologist with experience in advanced laparoscopy is recommended. A large tumor diameter was associated with the necessity of conversion to laparotomy.
منابع مشابه
Place and modalities of laparoscopy in surgical management of suspected adnexal masses.
Only benign adnexal masses are suitable for treatment by operative laparoscopy. Ovarian cancer must always be managed by midline laparotomy. In our experience the preoperative workup (clinical examination, study of past history, trans vaginal ultrasonography, doppler, tumoral markers etc.) together with the diagnostic phase of laparoscopy provide a sensitivity value of 100%, a positive predicti...
متن کاملI-41: Imaging Strategy for Diagnosis of Adnexal Masses Including US,CT Scan and MRI
Adnexal masses are spectrum of diseases from benign non neoplastic and neoplastic masses to malignant neoplasms. Endovaginal ultrasonography (US) is the fisrt and invaluable modality for assessment of adnexal masses because it is available and has a high negative predictive value. Important morphologic features are solid (vascularized) tissue, vascular and thick septations, and papillary projec...
متن کاملAdnexal Masses and Pregnancy: A 10-Year Experience
Background and Objectives: The diagnosis of pregnancy associated adnexal masses is rising due to routine utilization of sonography in prenatal care. The purpose of this study was to describe pregnancy associated adnexal masses over a period of 10 years. Patients and Methods: A retrospective study was reviewed hospital records of all pregnant women with adnexal mass that underwent surgical rese...
متن کاملStrict Criteria for Selection of Laparoscopy for Women with Adnexal Mass
OBJECTIVES We compared the indication of laparoscopy for treatment of adnexal masses based on the risk scores and tumor diameters with the indication based on gynecology-oncologists' experience. METHODS This was a prospective study of 174 women who underwent surgery for adnexal tumors (116 laparotomies, 58 laparoscopies). The surgeries begun and completed by laparoscopy, with benign pathologi...
متن کاملSelected Adnexal Cystic Masses in Postmenopausal Women Can be Safely Managed by Laparoscopy
The aim of this study was to assess the efficacy and safety of laparoscopic treatment for adnexal cystic masses that were predicted to be benign in postmenopausal women. Postmenopausal women found to have an adnexal cystic mass were retrospectively evaluated with transvaginal ultrasonography, and serum CA-125 levels. The selection criteria were adnexal cystic masses greater than 3 cm but less t...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia
دوره 36 3 شماره
صفحات -
تاریخ انتشار 2014