Laparoscopic management of selected adnexal masses.

STUDY OBJECTIVE

To investigate the significance, safety, and intraoperative and immediate postoperative outcomes of laparoscopic management of adnexal masses thought to be at low risk for malignancy.

DESIGN

Prospective cohort study (Canadian Task Force classification II-2).

SETTING

Tertiary-care teaching hospital.

PATIENTS

Two hundred twenty women undergoing laparoscopic surgery for adnexal masses.

INTERVENTIONS

Laparoscopic treatment including cystectomy, oophorectomy, adnexectomy, and peritoneal cytology, and, if necessary, frozen sections. A histologic diagnosis was obtained in every patient.

MEASUREMENTS AND MAIN RESULTS

Only one ovarian cancer and one borderline ovarian tumor were diagnosed by histologic examination, and both were managed by laparotomy. The remaining 218 patients had laparoscopy for benign adnexal masses.

CONCLUSION

Operative laparoscopy with the finding of incidental ovarian malignancy is rare, as shown by pathologic examination. With appropriate preoperative evaluation, laparoscopic surgery is technically feasible, safe, and advantageous, with minimal morbidity, and should replace laparotomy in the management of most adnexal masses. (J Am Assoc Gynecol Laparosc 6(3):313-316, 1999)