[Laparoscopy and laparotomy in the operative treatment of ovarian cysts].

OBJECTIVES

The purpose of our study was to compare operative procedures, histologic types of tumours, and intra- and postoperative complications of patients operated for benign ovarian cysts by laparotomy or laparoscopy.

MATERIALS AND METHODS

257 patients with different types of ovarian cysts underwent operations by laparoscopy (51 cases) or laparotomy (206 cases). Careful selection for operative treatment was made on the basis of clinical findings, ultrasound scans (using colour Doppler), patient's age and history. Operative laparoscopies were performed in patients with "unsuspected" ovarian cysts with diameter < or = 8 cm. During every operation, a histologic examination of tumour was performed.

RESULTS

In 42 patients the cysts were found in both ovaries. Remaining 215 women had unilateral ovarian tumours. Adnexectomy was carried out in 142 cases, cystectomy in 131, ovariectomy in 18, and aspiration and electrocoagulation of ovarian cysts in 8 cases. The most common laparoscopic procedures were cystectomy (41) and aspiration and electrocoagulation of ovarian cysts (8); while by laparotomy: adnexectomy (142) and cystectomy (131); p < 0.0001. The histopathological assessment showed as follows: serous cysts in 98 cases, dermoid cysts in 75, endometrial cysts in 63, mucous cyst in 23, and others (mainly haemorrhagic, functional cysts and fibrothecomas) in 40 cases. The incidence of operative complications (3/257--all due to insufficient hemostasis) and postoperative complications (infection--7/257, anaemia--4/257, peritonitis--1/257) was rather low and similar in patients operated by laparoscopy and laparotomy. Patients were generally discharged from the hospital on the fourth (median) postoperative day after laparoscopies and the seventh (median) day after laparotomies (p < 0.0005).

CONCLUSIONS

Operative treatment of ovarian benign cysts is connected with a very low risk for intra- and postoperative complications. The operative laparoscopy brings better cosmetic effects and seems to be safe and effective method of treatment of ovarian benign cysts.