Adnexal masses suspected to be benign treated with laparoscopy

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Ovarian Cancer Screening

Background:

• Established guidelines by the American College of Obstetrician Gynecologists (ACOG) exist for referring women with suspicious pelvic masses to gynecologic oncologists.
• Evaluating the negative predictive value of these ACOG guidelines is crucial for appropriate patient triage.

Purpose of the Study:

• To assess the negative predictive value of ACOG Committee Opinion 280 Triage Criteria for ovarian malignancy.
• To evaluate a modified algorithm using minimally invasive surgery for adnexal masses suspected to be benign.

Main Methods:

• 257 patients with adnexal masses (8-13cm) meeting ACOG Triage Criteria underwent operative laparoscopy, adnexectomy, and colpotomy.
• Data collected on treatment completion, outpatient status, surgery duration, blood loss, complications, and reoperation rates.

Main Results:

• The negative predictive value of ACOG criteria was 95.57% (premenopausal) and 90.91% (postmenopausal) for excluding invasive ovarian malignancy.
• 97.5% of patients were treated as outpatients with a low incidence of complications and iatrogenic rupture.

Conclusions:

• Laparoscopic adnexectomy is a safe and effective minimally invasive approach for selected patients with ovarian masses.
• ACOG Committee Opinion 280 Triage Criteria are confirmed as valuable for deselection and can form the basis of a new treatment algorithm.