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The management of certain ovarian cysts has evolved from the traditional and often quite radical surgical approach to a more conservative approach. Much of this change can be attributed to the improvement in laparoscopic surgical technique. After a brief discussion of the differential diagnosis and clinical presentation of ovarian cysts, ultrasonog...
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The primary objectives of the present study are to determine the period of onset of ovarian insufficiency after surgery and to confirm potential risk factors for ovarian insufficiency after surgery for the removal of benign ovarian cysts. Data were obtained from 75 patients who underwent surgery for benign ovarian cysts prior to the onset of ovaria...
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Citations
... Management of these cysts is mandated when there is chance for malignancy (cysts larger than 4 cm and abnormal serum CA-125 levels) and intolerable symptoms. Surgical removal of the cysts is required for persistent ones measuring 5-10 cm which have not shown any shrinkage after expectant management for several cycles should be considered (5). ...
Benign ovarian cysts are common among both pre- and postmenstrual women. Surgical intervention for excision of an ovarian cyst is mandated when symptomatic, or chance for malignancy is high. The damaging effect of surgical ovarian cystectomy on ovarian reserve is debated in recent studies.
In the present study we investigated serum level of anti-mullerian hormone (AMH) as an indicator of ovarian reserve before and after surgical cystectomy.
60 patients with dermoid cyst, serous cystadenoma, and mucinous cystadenoma were recruited. Measurement of serum AMH was performed prior to surgery, and at one and 3 months after laparoscopic cystectomy. Serum AMH levels were compared before and after the surgery and between various types of ovarian cyst.
Serum AMH level declined significantly after the surgery which recovered to 65% of its baseline value three months later.
Decreased serum AMH can be contributed to decreased ovarian reserve after laparoscopic ovarian cystectomy. This can result from thermo-coagulation used for hemostasis during the operation.
... Some studies reported the pathogenesis of OC, repeated attack of chronic pelvic inflammation, environment, endocrine as well as stress, virus etc. are accepted as the reasons. There are various classifications in clinics [3].The symptoms shared by most types of OC are occasional lower abdominal pain with or without lump, irregular monthly period, dysmenorrhea, leukorrhagia, dyspareunia or vomiting etc. ...
Ovarian cyst (OC) is one of the biggest concerns of women around the world. With the increase in the number of cases of OC, it seems like no woman is safe from this dreaded disease. Traditional Chinese Medicine (TCM) has its advantage in OC management, while due to the complexity and opacity; it is hard to clarify the rules of Chinese herbs. Text mining is a useful method to explore the regularity; we put this technology in principle research of Chinese herbal medicine (CHM) and associated it with patterns of TCM in OC treatment. The results we obtained from this study:Fuling, Guizhi, Taoren, Danpi, Chishao are top five herbs frequently used in OC. The pattern of Qi stagnation and blood stasis is the No.1 syndrome, which is highly coincided with the top lists of the herbs. Conclusion: Text mining is a practical technology, which can help with the research field of medicine regularity and assist the physician with clinical decision; the future research shall be benefited from the outcome mined out by this technology.
Introduction:
Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome.
Methods:
A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed.
Results:
Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23%) and endometriotic cyst (n=14; 41.17%). Out of 34 cases, five cases of endometriotic cyst (14.70%) were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82%) and subcutaneous emphysema (n=1; 2.9%) were present.
Conclusions:
Laproscopic management of benign ovarian masses is safe and feasible.
To assess the use of transvaginal ultrasound guidance during operative laparoscopy.
Five of 98 consecutive cases of operative laparoscopy for benign-appearing ovarian cysts were complicated by extensive intrapelvic adhesions and a distorted anatomy. Following prolonged dissection, simultaneous transvaginal ultrasonography was used in these cases.
In all cases we were able to ultrasonographically image and locate the ovarian cyst during the laparoscopic procedure. In four cases this was a significant aid in expediting the procedure and avoiding damage to adjacent pelvic structures. In one case, identification of the ovarian cyst facilitated the decision to resort to laparotomy.
In selected cases, laparoscopic surgeons should be aware of the feasibility and possible benefits of the use of simultaneous intraoperative transvaginal ultrasonography.
Personal experience in videolaparoscopic treatment of 42 ovarian masses during the period September 1991-December 1995 is reported. Seven patients have been operated in emergency, 35 in election. Resection of the masses has been performed by two methods: dissection and electrocoagulation, generally preferred in benign functional cysts; resection by stapler (endo GIA).
In 5 of the patients operated in emergency an hemoperitoneum was found because of the rupture of ovarian cyst; in the other two cases, respectively, a necrotic benign cyst twisted on the adnexal axis and a dermoid cyst twisted and necrotic too were found. In the 35 patients operated in election, 33 benign cysts, 1 serous cystoadenoma 1 granulosa tumour were observed. Postoperative course was always excellent, with no painful symptomatology and hospital-stay and convalescence extremely reduced (dismission from hospital approx two days after the operation).
The different aspects which must be evaluated before choosing mini-invasive treatment are discussed. An accurate preoperative study especially by sonography and serous hormonal dosage (in particular CA 125), besides good surgical experience of the operator, are fundamental requisites in order to minimize risks of this procedure and guarantee excellent results.
Laparoscopic surgery has clear advantages over open surgical procedures. In gynecology, laparoscopic surgery for adnexal masses in pre or post menopausal women has been used for several years.
To report the experience with gynecologic laparoscopic surgery at the Temuco Regional Hospital.
Between 1996 and 1998, laparoscopic surgery was done in 96 patients aged 16 to 56 years and open surgery in 56 patients aged 15 to 74 years, with a clinical or ultrasound diagnosis of adnexal masses or ovarian dermoid cysts.
The most frequent tumors excised were epithelial and germinal cell. Laparoscopic surgery required a mean operative time of 69.9 min and it had a 3.1% of complications. Women subjected to this type of surgery had a mean hospital stay of 3.1 days and the mean postoperative stay was 2 days. Open surgery required an operative time of 69 min and it had no postoperative complications. The mean hospital stay for women subjected to this type of procedure was 9.5 days.
Women subjected to laparoscopic surgical procedures for adnexal masses had a shorter hospital stay than women subjected to open surgical procedures.
