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Laparoscopic excision of adnexal masses
Riccardo Marana1, Ludovico Muzii, Giovan Fiore Catalano
1Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
Summary
Laparoscopic management of adnexal masses is safe and effective in carefully selected patients. Strict preoperative criteria minimize risks, with a low rate of unexpected malignancies and no adverse impact on prognosis.
Area of Science:
- Gynecologic Surgery
- Minimally Invasive Procedures
- Oncology
Background:
- Adnexal masses are common in women under 40.
- Accurate preoperative selection is crucial for successful surgical management.
- Laparoscopy is increasingly used for adnexal mass removal.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic management for adnexal masses.
- To assess the rate of unexpected malignancies in selected patients.
- To determine if laparoscopy impacts patient prognosis.
Main Methods:
- Prospective study of 683 consecutive patients under 40 with specific ultrasonographic criteria for adnexal cystic masses.
- Laparoscopic excision of 1069 cysts.
- Follow-up to assess outcomes and histology.
Main Results:
- 667 patients were managed entirely by laparoscopy; 13 cases required conversion to laparotomy.
- Histology revealed endometrioma (57%), serous cyst (13%), dermoid (12%), and others.
- Ovarian malignancies (borderline or early invasive) were found in 1.2% of patients, all disease-free after follow-up.
Conclusions:
- Strict preoperative and intraoperative selection allows for safe laparoscopic management of adnexal masses.
- The incidence of unexpected malignancies was low (1.2%).
- Laparoscopic approach did not negatively affect the prognosis of patients with malignancies.