Surgical management of non-epithelial ovarian malignancies: advantages and limitations of laparoscopy.

OBJECTIVE

To compare open and laparoscopic surgery in the management of non-epithelial ovarian malignancies.

STUDY DESIGN

Retrospective study from University Hospital of Clermont-Ferrand, France, of 20 patients undergoing surgery for non-epithelial ovarian malignancies. We compared the outcome of 13 open surgeries and 7 laparoscopic surgeries. The main outcome measures were stage and size of the tumor, surgical procedure, hospital stay, adjuvant treatment, follow-up and fertility.

RESULTS

The mean age of the patients and the type of tumor at the time of diagnosis were similar in the two groups but the tumor size was significantly larger in the laparotomy group (14.0cm vs. 6.7cm; p<0.05). Treatment was conservative in 85.6% vs. 61.5% in the laparoscopy and laparotomy groups respectively. Tumor stages were not statistically different in the two groups. The hospital stay was shorter in the laparoscopy group (3.1 days vs. 6.9 days p=0.03) and there were no differences in terms of complications, surgical procedures, number of lymph nodes removed and adjuvant treatment.

CONCLUSIONS

Laparoscopy respecting the usual oncologic principles appears to be a good alternative to laparotomy for the initial management of non-epithelial ovarian malignancies. The limiting factors of this technique remain the tumor size, the tumor stages and the surgeon's experience.