Gynaecology Research Today is a free monthly online journal that collates and summarizes the latest research about Gynaecology, including details on pap smears, laparoscopy, ultrasound, hysteroscopy.

Efficacy of laparoscopically-assisted extracorporeal cystectomy in patients with ovarian endometrioma.

Ceyhan T, Atay V, Gungor S, Karateke A, Oral O, Baser I

Department of Obstetrics and Gynaecology, Gulhane Military Medical Academy and Medical School, Ankara, Istanbul, Turkey. stceyhan@gata.edu.tr

STUDY OBJECTIVE: To investigate the usefulness and effectiveness of the extracorporeal surgical technique in the treatment of endometriomas. DESIGN: Retrospective evaluation (Canadian Task Force Classification II-2). SETTING: Department of gynecology in a tertiary care faculty hospital and training hospital. PATIENTS: Of 89 patients with endometrioma, 53 had laparoscopic stripping, and 36 had laparoscopically-assisted extracorporeal cystectomy. INTERVENTIONS: Laparoscopic stripping and laparoscopically-assisted extracorporeal cystectomy were performed for the treatment of endometriomas diagnosed laparoscopically. MEASUREMENTS AND MAIN RESULTS: The size of the endometrioma diagnosed by the ultrasonographic examination was not statistically related to the severity of the endometriosis (p = .42). Conversion to extracorporeal technique was required in 17 of 58 cases with moderate endometriosis and 14 of 31 cases with severe endometriosis (p = .04). Operation time, visual analogue pain score, and hospitalization periods were similar between the 2 techniques. Among 53 specimens obtained with laparoscopic stripping, 29 (55%) had no ovarian tissue, and 24 (45%) had ovarian tissue with follicles. Of 36 specimens obtained with extracorporeal technique, 19 (52%) had no ovarian tissue, and 17 (48%) had ovarian tissue with follicles. Preservation of the ovarian tissue was not significantly different between both surgical techniques. CONCLUSIONS: Extracorporeal technique with laparoscopically-assisted minilaparotomy is a valuable alternative for laparoscopic stripping in selected cases.

Published 10 March 2006 in J Minim Invasive Gynecol, 13(2): 145-9.
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