01 April 2010
Laparoscopic surgery for the management of ovarian endometriomas
Bruno MossaA, Valeria EbanoB, Stefania TucciC, Caterina RegaD, Emiliano DolceE, Antonio FregaF, Rosalia MarzianiGMed Sci Monit 2010; 16(4): MT45-50 :: ID: 878489
Abstract
Background
Treatment for mild and moderate endometriosis is controversial, whereas ovarian endometriomas of diameter > 3 cm must be treated surgically. A minimally invasive and inexpensive surgical approach should be always preferred. The objective of this randomized, prospective, clinical trial was to assess operative time, hemostasis, accuracy, recurrence rates, and pregnancy outcomes of 2 different laparoscopic techniques for management of ovarian endometriomas.
Material and Method
Ninety-two patients with ovarian endometriomas were randomized to undergo direct stripping of cystic wall from the initial adhesion site (group A), or circular excision of ovarian tissue around the initial adhesion site and then stripping (group B). Pregnancy outcome results were retrieved at 36 months after surgery. Recurrence rate corresponded to evaluation at 4 and 12 months after surgery performed by transvaginal ultrasound and Ca125 serum level.
Results
Direct stripping leads to bleeding more frequently than does circular excision. Hemostasis at the ovarian hilus does show differences between groups; an easy exposure of damage after circular excision reduces execution time. Cumulative pregnancy outcomes at 36 months, and recurrence rates during follow-up, did not significantly differ among techniques.
Conclusions
Circular excision of endometrioma cystic wall reduces surgical time, and results in better hemostasis. In addition, excision techniques allow complete removal of the cystic wall in 93% of cases (compared to 74.5% for direct stripping technique), showing differences in recurrence rate, and bringing about a better pregnancy. Data are not statistically significant owing to the small number of collected cases.
Keywords: Pregnancy, Pregnancy Outcome, Ovary - pathology, Ovarian Neoplasms - surgery, Membrane Proteins - biosynthesis, Medical Oncology - methods, Laparoscopy - methods, Hemostasis, Endometriosis - surgery, CA-125 Antigen - biosynthesis, Recurrence
Editorial
01 May 2024 : Editorial
Editorial: First Regulatory Approval for Adoptive Cell Therapy with Autologous Tumor-Infiltrating Lymphocytes (TILs) – Lifileucel (Amtagvi)DOI: 10.12659/MSM.944927
Med Sci Monit 2024; 30:e944927
In Press
12 Mar 2024 : Clinical Research
Tissue Inhibitors of Metalloproteinase 1 (TIMP-1) and 3 (TIMP-3) as New Markers of Acute Kidney Injury Afte...Med Sci Monit In Press; DOI: 10.12659/MSM.943500
12 Mar 2024 : Review article
Optimizing Behçet Uveitis Management: A Review of Personalized Immunosuppressive StrategiesMed Sci Monit In Press; DOI: 10.12659/MSM.943240
12 Mar 2024 : Clinical Research
Metabolomic Alterations in Methotrexate Treatment of Moderate-to-Severe PsoriasisMed Sci Monit In Press; DOI: 10.12659/MSM.943360
14 Mar 2024 : Clinical Research
Renal Dysfunction Increases Risk of Adverse Cardiovascular Events in 5-Year Follow-Up Study of Intermediate...Med Sci Monit In Press; DOI: 10.12659/MSM.943956
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952