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Samejima K, Takai Y, Matsunaga S, Nagai T, Kikuchi A. The safety and effectiveness of elective laparoscopic surgery for benign ovarian cysts during pregnancy-Comparison with emergency surgery. J Obstet Gynaecol Res 2022; 48:2603-2609. [PMID: 35882386 DOI: 10.1111/jog.15357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022]
Abstract
AIM Relatively small benign ovarian cysts are conservatively managed in early pregnancy. However, emergency surgery is required should acute abdomen occur. Our study aimed to examine and compare the outcomes of benign ovarian cysts treated with elective laparoscopic surgery or emergency surgery during pregnancy. METHODS From 2004 to 2017, we treated 135 pregnant patients (110 elective and 25 emergencies) with benign ovarian cysts at our tertiary perinatal center and compared their surgical and perinatal outcomes. RESULTS There was no significant difference in cyst diameter (7.6 ± 2.5 vs. 6.8 ± 2.1 cm), but cysts <6 cm were significantly more common in emergency (36%) than in elective (15%) cases. Mature teratomas were significantly more common in elective cases (89% vs. 52%) but corpus luteum cysts were more common in emergency cases (0% vs. 32%). The rates of laparoscopic surgery (98.2% vs. 52.0%) and ovarian conservation (99.1% vs. 80.0%) were significantly higher, and post-surgical hospitalization (4.6 ± 1.3 vs. 9.8 ± 10.5 days) was significantly shorter in elective than in emergency cases. There was no significant difference in the gestational age for delivery (38.9 ± 1.9 vs. 38.4 ± 2.7 weeks), preterm birth rate (12% vs. 20%), or birth weight (2939 ± 469 vs. 3019 ± 510 g). CONCLUSIONS We cannot state that an emergency surgery during pregnancy is rarely required for small benign ovarian cysts. However, the surgical outcomes were significantly better for elective than for emergency surgery, with no difference in perinatal outcomes. If a benign ovarian cyst is found early in pregnancy, elective laparoscopic surgery may be considered with adequate informed consent.
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Affiliation(s)
- Kouki Samejima
- Department of Obstetrics and Gynecology, Saitama Medical Center/ Saitama Medical University, Kawagoe, Saitama, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center/ Saitama Medical University, Kawagoe, Saitama, Japan
| | - Shigetaka Matsunaga
- Department of Obstetrics and Gynecology, Saitama Medical Center/ Saitama Medical University, Kawagoe, Saitama, Japan
| | - Tomonori Nagai
- Department of Obstetrics and Gynecology, Saitama Medical Center/ Saitama Medical University, Kawagoe, Saitama, Japan
| | - Akihiko Kikuchi
- Department of Obstetrics and Gynecology, Saitama Medical Center/ Saitama Medical University, Kawagoe, Saitama, Japan
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Fayez I, Khreisat B, Athamneh T, Omoosh R, Daibes MA. Multiple Bilateral Ovarian Mature Cystic Teratomas with Ovarian Torsion: A Case Report. Oman Med J 2018; 33:163-166. [PMID: 29657687 DOI: 10.5001/omj.2018.30] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Ovarian tumors are a common form of neoplasm in women. Mature cystic teratoma is the most common type, with a bilateral incidence of 8-15%. However, few cases are reported as bilateral and multiple. A rare case of bilateral multiple dermoid cysts in a 19-year-old female patient presented with abdominal pain of one-day duration. Her medical history was unremarkable. Ultrasonography showed multiple bilateral ovarian cystic masses. The patient underwent laparotomy. The masses were excised while preserving the remaining ovarian tissue. Histopathology confirmed the diagnosis of multiple mature cystic teratomas with no presence of malignant tissue.
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Affiliation(s)
- Iman Fayez
- Department of Obstetrics and Gynecology, King Hussein Medical Center, Amman, Jordan
| | - Basel Khreisat
- Department of Obstetrics and Gynecology, King Hussein Medical Center, Amman, Jordan
| | - Tarek Athamneh
- Department of Obstetrics and Gynecology, Prince Rashid Ibn Al-Hasan Hospital, Irbid, Jordan
| | - Reema Omoosh
- Department of Obstetrics and Gynecology, King Hussein Medical Center, Amman, Jordan
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Pitiakoudis M, Romanidis K, Nagorni EA, Kouklakis G, Tsalikidis C, Botaitis S, Iatrou C, Simopoulos C. Successful Management of a Truly Large Serous Cystadenoma with Laparoscopic Surgery: A Case Report and Literature Review. J Gynecol Surg 2013. [DOI: 10.1089/gyn.2012.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michael Pitiakoudis
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
| | - Eleni-Aikaterini Nagorni
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
| | - Georgios Kouklakis
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Christos Tsalikidis
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
| | - Sotirios Botaitis
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
| | - Christos Iatrou
- Department of Anesthesiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Constantinos Simopoulos
- Second Department of Surgery, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis, Greece
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Biscette S, Yoost J, Hertweck P, Reinstine J. Laparoscopy in pregnancy and the pediatric patient. Obstet Gynecol Clin North Am 2012; 38:757-76. [PMID: 22134021 DOI: 10.1016/j.ogc.2011.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Minimally invasive surgery is now standard of care for many procedures in pediatric gynecology. Laparoscopy has been well documented to produce faster recovery,decreased postoperative pain, and because of smaller incisions, a better cosmetic result. These are important when considering an active pediatric patient. Although a laparoscopic approach to endometriosis, adnexal masses, and ovarian torsion are well supported in the literature in the pediatric patient, more data are needed with regard to SILS in younger patients. Laparoscopy seems to be a better approach to oopheropexy in children undergoing radiation, and in resection of certain mullerian anomalies; however, the numbers are low.Similarly in pregnant patients, laparoscopy provides for shorter recovery times,decrease analgesic use and shorter hospital stays. Concerns about poor fetal outcomes in surgery during pregnancy for non gynecologic problems have been brought to light; however, the evidence indicates that these outcomes can be attributed to the nature of the underlying disease and not the surgical approach. With regard to pneumoperitoneum the effect of CO2 insufflation on fetal physiology and long-term outcomes remains unclear, and will continue to be an issue of controversy until larger studies are published.With both the pediatric and pregnant populations, laparoscopic complications can be diminished when performed by skilled surgeons with strict adherence to good technical principles. The advantages of laparoscopy are great, and this approach should be considered in pediatric and pregnant patients.
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Affiliation(s)
- Shan Biscette
- Department of Obstetrics, Gynecology and Women's Health, Kosair Children's Hospital, Louisville, KY 40207, USA
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Dhuliya DJ, Rahana F, Al Wahibi A, Al Mamari MS, Al Mamari AM, Devi N, Jahan A, Dar MA, Al Madhani A, Al Kindi S. Largest Serous Cystadenoma in the first Trimester treated Laparoscopically: A Case Report. Oman Med J 2012; 27:e030. [PMID: 28861184 PMCID: PMC5563912 DOI: 10.5001/omj.2012.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 11/21/2011] [Indexed: 11/03/2022] Open
Abstract
We report the first case of a giant serous cystadenoma approximately 7.5kg in weight in a 28-year old primigravida at 8 weeks of gestation which was successfully excised laparoscopically. Postoperatively, she had a quick recovery and she was discharged on post op day 3 with an intact pregnancy and no complications. This is the largest ovarian cyst in early pregnancy that has been ever reported from our hospital. We also believe this cyst to be the largest cyst in early pregnancy ever reported in the literature that has been managed by Laparoscopy.
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Affiliation(s)
| | - Farah Rahana
- Consultant, Obestetrics and Gynecology Department, Sohar Hospital, Sohar, Sultanate of Oman
| | | | | | | | - Nirmala Devi
- Consultant, Obestetrics and Gynecology Department, Sohar Hospital, Sohar, Sultanate of Oman
| | - Arif Jahan
- Consultant, Obestetrics and Gynecology Department, Sohar Hospital, Sohar, Sultanate of Oman
| | - Manzoor A. Dar
- Consultant, Department of General Surgery, Sohar Hospital, Sohar, Sultanate of Oman
| | - Ali Al Madhani
- Consultant, Department of General Surgery, Sohar Hospital, Sohar, Sultanate of Oman
| | - Salam Al Kindi
- Hematology Department, Sohaar Hospital, Sohar, Sultanate of Oman
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Kim WC, Kwon YS. Laparoendoscopic single-site surgery for exteriorization and cystectomy of an ovarian tumor during pregnancy. J Minim Invasive Gynecol 2010; 17:386-9. [PMID: 20417433 DOI: 10.1016/j.jmig.2009.12.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 12/28/2009] [Accepted: 12/31/2009] [Indexed: 11/17/2022]
Abstract
Herein, we describe a surgical approach for management of a pregnant woman with an ovarian tumor using laparoendoscopic single-site surgery with exteriorization. We assessed both the feasibility and cosmetic outcome. The operation lasted 25 minutes, and the estimated blood loss was negligible. No perioperative or postoperative complications developed, and the patient was discharged on postoperative day 2.
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Affiliation(s)
- Woo-Chul Kim
- Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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Abstract
PURPOSE OF REVIEW The acute abdomen remains a challenge for all physicians who take part in the care of women in pregnancy. Obstetricians must be abreast of current topics, especially critical when having to consult other specialties for assistance in managing these conditions. RECENT FINDINGS We will highlight recent observations in the literature concerning the ability to perform laparoscopy safely in pregnancy, the accuracy of diagnosing appendicitis, and new methods to accurately diagnose urolithiasis with less ionizing radiation effect on the fetus. Finally, with the proficiency of laparoscopy and choledochoscopy improving, we will review several articles underlining their safety. SUMMARY Laparoscopy appears to be well tolerated in pregnancy, but larger multicenter prospective studies are required to make better recommendations concerning its use, with a registry needed to facilitate this endeavor. Conservative management of gallstone pancreatitis may fall out of favor, and choledochoscopy for symptomatic gallstones in the biliary tree may become the treatment of choice. Most cases of urolithiasis resolve with conservative management, but the possibility of preterm labor in these patients must be recognized and newer imaging techniques for diagnosis containing less radiation be used. Adnexal torsion in pregnancy may be another condition that is managed through the laparoscope as the gynecologic community's laparoscopic skills improve.
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Current world literature. Curr Opin Obstet Gynecol 2008; 20:602-7. [PMID: 18989138 DOI: 10.1097/gco.0b013e32831ceeb3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kitade M, Takeuchi H, Kumakiri J, Shimanuki H, Kikuchi I, Takeda S. Instruments and Techniques: Two-Puncture Extracorporeal Method—a New Technique for Laparoscopic Management of Ovarian Tumors Detected During Pregnancy. J Gynecol Surg 2008. [DOI: 10.1089/gyn.2008.b-02301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mari Kitade
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Takeuchi
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Jun Kumakiri
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroto Shimanuki
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Iwaho Kikuchi
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan
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