Title: Laparascopic Evaluation and Management of Benign Adnexal Masses
Authors: Kiran Aggarwal, Kavita Pandey
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.37
Abstract
Introduction: Benign adnexal masses can be effectively managed by laparoscopy. Laparoscopy provides the advantage of diagnosis and therapy at the same time. The risk of ovarian malignancy in women undergoing laparoscopy for preoperatively benign appearing ovarian tumors ranges from 0.1 to 4.2%.The promises of less postoperative pain, faster recovery, and lower costs have driven patients demand, and more gynaecologic procedures are now performed laparoscopically than in past.
Material and Methods: 35 patients with benign adnexal masses were included in the study needing surgery as per inclusion and exclusion criterion. Diagnostic laparoscopoy was followed by operative laparoscopy. Per op diagnosis was compared with histopathology. Surgical procedure, time taken, blood loss, preoperative and postoperative complications were studied and recorded.
Results: The mean age of patients was 30±7.33 years, majority being nullipara. Simple serous cyst (28.5%) and dermoid (17.1%). were the common preoperative diagnosis. Laparoscopic Cystectomy (31.43%) and cystectomy with chromopertubation (22.86%) were the most common procedures performed. Majority of the procedures was completed between 60-90 min. Mean blood loss was found to be 46.86ml. Conversion to laparotomy (11.43%) and cyst rupture (5.7%) were the most common per op complications. Laparoscopic diagnosis was found to be excellent for dermoid(sensitivity 100%specificity 100%), hemorrhagic cyst(sensitivity 100%specificity 100%), paraovarian cyst(sensitivity 100%,specificity 100%), good for simple serous cyst (sensitivity 83.33%,specificity 83.33%)and mucinous cyst(sensitivity 50%,specificity 96.56%).
Conclusion: Laparoscopic management of benign adnexal masses is safe effective and is both diagnostic and therapeautic at the same time. Post operative complications are negligible and in properly selected cases finding a malignancy is rare.
Key Words: Laparoscopic management, Benign adnexal masses, laparoscopic complications.
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