Application of single-site laparoscopy in the removal of giant ovarian cysts

doi:10.3877/cma.j.issn.1674-6899.2018.06.005

Abstract

Abstract:

Objective

To evaluate single-port laparoscopic surgery in the removal of giant cysts of the ovary.

Methods

We retrospective analyzed the clinical data of 9 patients with giant ovarian cysts who underwent single-port laparoscopic assisted extracorporeal ovarian cystectomy at gynecology department of Peking Union Medical College Hospital from Mar.2017 to Mar.2018. Among them 2 patients were pregnant at 13⁺ weeks. The postoperative histology showed 5 patients were mucinous cystadenoma, 2 were teratoma, 1 was endometriotic cyst and 1 was simple cyst.

Results

All the 9 patients successfully completed the removal of giant ovarian cysts with the assistance of single-port laparoscopy. No patients were converted to laparotomy or multi-port laparoscopy. The median operation time was 55 min (35-60 min), the median bleeding volume was 10 ml(10-75 ml), and average the hospital stay was (5.11±1.41 days). Term delivery was noted in 2 pregnant women. One patient had a natural pregnancy in 3 months after operation, and the other six patients had no recurrence after 6-12 months.

Conclusions

Single-port laparoscopic assisted extracorporeal ovarian cystectomy provides an alternative method for the treatment of giant ovarian cysts.

Key words: Single-site laparoscopic cystectomy, Gaint ovarian cyst

Danying Wang, Haiyuan Liu. Application of single-site laparoscopy in the removal of giant ovarian cysts[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(06): 331-334.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2018.06.005

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References 18

[1]	Mimoun C, Fritel X, Fauconnier A, et al. Epidemiology of presumed benign ovarian tumors[J]．J Gynecol Obstet Biol Reprod (Paris)，2013，42(8)：722-729.
[2]	Eltabbakh GH, Charboneau AM, Eltabbakh NG. Laparoscopic surgery for large benign ovarian cysts[J]. Gynecol Oncol，2008，108(1)：72-76.
[3]	Yi SW. Minimally invasive management of huge ovarian cysts by laparoscopic extracorporeal approach[J]. Minim Invasive Ther Allied Technol，2012，21(6): 429-434.
[4]	Park JY, Kim TJ, Kang HJ, et al. Laparoendoscopic single site (LESS) surgery in benign gynecology: perioperative and late complications of 515 cases[J]. Eur J Obstet Gynecol Reprod Biol，2013，167(2)：215-218.
[5]	Goh SM, Yam J, Loh SF, et al. Minimal access approach to the management of large ovarian cysts[J]. Surg Endosc，2007，21(1): 80-83.
[6]	Vergote I, De Brabanter J, Fyles A，et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma[J]. Lancet，2001，357(9251): 176-182.
[7]	Clement D, Barranger E, Benchimol Y, et al. Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture[J]. Surg Endosc，2003，17(4): 658-658.
[8]	Chong GO, Hong DG, Lee YS. Single-port (octoport) assisted extracorporeal ovarian cystectomy for the treatment of large ovarian cysts: compare to conventional laparoscopy and laparotomy[J]. J Minim Invasive Gynecol，2015，22(1): 45-49.
[9]	Song T, Kim MK, Kim ML, et al. Laparoendoscopic single-site surgery for extremely large ovarian cysts: a feasibility, safety, and patient satisfaction study[J]. Gynecol Obstet Invest，2014，78(2): 81-87.
[10]	Ye LY, Wang JJ, Liu DR, et al. Management of giant ovarian teratoma: a case series and review of the literature[J]. Oncol Lett，2012，4(4): 672-676.
[11]	Alobaid A, Memon A, Alobaid S, et al. Laparoscopic management of huge ovarian cysts[J]. Obstet Gynecol Int，2013，2013(6)：380854-380854.
[12]	Takeda A, Imoto S, Nakamura H. Gasless laparoendoscopic single-site surgery for management of adnexal masses during pregnancy[J]. European Journal of Obstetrics & Gynecology, 2014, 180(1)：28-34.
[13]	刘海元，孙大为，张俊吉，等．《妇科单孔腔镜手术技术专家共识》解读[J/CD]．中华腔镜外科杂志(电子版)，2017，10(1)：1-6.
[14]	Rosen MP, Johnstone E, McCulloch CE, et al. A characterization of the relationship of ovarian reserve markers with age[J]. Fertil Steril，2012，97(1): 238-243.
[15]	Koninger A, Koch L, Enekwe A, et al. Change of anti-Mullerian-hormone levels during follicular phase in PCOS patients[J]. Gynecol Endocrinol，2015，31(1): 26-30.
[16]	Fanchin R, Taieb J, Lozano DH, et al. High reproducibility of serum anti-Mullerian hormone measurements suggests a multi-staged follicular secretion and strengthens its role in the assessment of ovarian follicular status[J]. Hum Reprod，2005，20(4): 923-927.
[17]	Owczarek D, Malinowski A, Wilczynski M. Ovarian reserve evaluation after laparoscopic cyst enucleation, depending on applied haemostasis technique and with particular consideration of endometrial cysts[J]. Prz Menopauzalny，2018, 17(1): 22-27.
[18]	Takeda A, Hayashi S, Imoto S, et al. Pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation[J]. J Obstet Gynaecol Res，2014，40(5)：1281-1287.

患者序号	年龄(岁)	体质量指数(kg/m²)	孕产(次)	CA125(U/ml)	CA19-9(U/ml)	病灶位置	囊肿直径(cm)	妊娠状态
1	17	17.1	G0P0	19.3	63.2	右侧	11	否
2	20	31.2	G0P0	18.6	22.8	左侧	13	否
3	26	21.7	G0P0	21.1	17.6	左侧	18	否
4	35	23.0	G0P0	13.7	8.6	右侧	20	否
5	27	26.0	G1P0	17.1	10.7	右侧	12	是(孕13^＋周)
6	25	19.3	G0P0	18.7	<0.6	左侧	13	否
7	20	26.0	G0P0	23.5	4.7	右侧	20	否
8	36	19.3	G1P0	13.8	5.5	左侧	10	否
9	28	22.4	G1P0	37.4	8.7	右侧	10	是(孕13^＋周)

患者序号	年龄(岁)	体质量指数(kg/m²)	孕产(次)	CA125(U/ml)	CA19-9(U/ml)	病灶位置	囊肿直径(cm)	妊娠状态
1	17	17.1	G0P0	19.3	63.2	右侧	11	否
2	20	31.2	G0P0	18.6	22.8	左侧	13	否
3	26	21.7	G0P0	21.1	17.6	左侧	18	否
4	35	23.0	G0P0	13.7	8.6	右侧	20	否
5	27	26.0	G1P0	17.1	10.7	右侧	12	是(孕13^＋周)
6	25	19.3	G0P0	18.7	<0.6	左侧	13	否
7	20	26.0	G0P0	23.5	4.7	右侧	20	否
8	36	19.3	G1P0	13.8	5.5	左侧	10	否
9	28	22.4	G1P0	37.4	8.7	右侧	10	是(孕13^＋周)

患者序号	手术时间(min)	术中出血量(ml)	住院时间(d)	术后并发症	术后最高体温(℃)	术后使用镇痛药物	术后病理类型	术后是否妊娠或分娩	术后复发
1	60	10	6	无	37.2	否	畸胎瘤	否	12个月无复发
2	40	50	5	无	37.4	否	黏液性囊腺瘤	否	12个月无复发
3	40	10	6	无	37.9	否	黏液性囊腺瘤	否	6个月无复发
4	120	100	7	无	39.1	是	黏液性囊腺瘤	孕18周	－
5	30	20	3	无	36.8	否	黏液性囊腺瘤	足月分娩	－
6	60	10	2	无	36.9	否	畸胎瘤	否	6个月无复发
7	55	200	7	无	38.5	否	黏液性囊腺瘤	否	6个月无复发
8	60	10	7	无	37.3	否	巧克力囊肿	否	6个月无复发
9	30	5	3	无	37.9	否	单纯囊肿	足月分娩	－

患者序号	手术时间(min)	术中出血量(ml)	住院时间(d)	术后并发症	术后最高体温(℃)	术后使用镇痛药物	术后病理类型	术后是否妊娠或分娩	术后复发
1	60	10	6	无	37.2	否	畸胎瘤	否	12个月无复发
2	40	50	5	无	37.4	否	黏液性囊腺瘤	否	12个月无复发
3	40	10	6	无	37.9	否	黏液性囊腺瘤	否	6个月无复发
4	120	100	7	无	39.1	是	黏液性囊腺瘤	孕18周	－
5	30	20	3	无	36.8	否	黏液性囊腺瘤	足月分娩	－
6	60	10	2	无	36.9	否	畸胎瘤	否	6个月无复发
7	55	200	7	无	38.5	否	黏液性囊腺瘤	否	6个月无复发
8	60	10	7	无	37.3	否	巧克力囊肿	否	6个月无复发
9	30	5	3	无	37.9	否	单纯囊肿	足月分娩	－

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