Nezhat C, Kearney S, Malik S, Nezhat C, Nezhat F. Laparoscopic management of ovarian remnant.
Fertil Steril 2005;
83:973-8. [PMID:
15820809 DOI:
10.1016/j.fertnstert.2004.12.006]
[Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Revised: 11/22/2004] [Accepted: 11/22/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE
To report outcomes of laparoscopic management of patients with ovarian remnant (OR).
DESIGN
Retrospective chart review.
SETTING
Referral practice and tertiary medical center.
PATIENT(S)
Sixty-four patients with confirmed OR who underwent laparoscopic treatment between July 1989 and September 2003.
INTERVENTION(S)
Laparoscopic excision of OR.
MAIN OUTCOME MEASURE(S)
Technical feasibility and recurrence.
RESULT(S)
Sixty-nine laparoscopies were performed to remove ovarian remnants, with five patients requiring two laparoscopies. Two cases were converted to laparotomy and one to mini-laparotomy for bowel resection. In 64% (41 out of 64), pelvic mass was diagnosed by imaging (35 by ultrasound, 5 by computerized tomography [CT], and 1 by both). The majority of ovarian remnants were found attached to one or more of the following: ureter, bowel, pelvic sidewall, bladder, rectum, and uterosacral ligament. Intraoperative complications occurred in four cases: three enterotomy and repair; one cystotomy and repair. Twelve minor postoperative complications occurred including urinary tract infection, hematuria, umbilical incision infection, and transient tachycardia. Three major postoperative complications occurred: one umbilical omental hernia, one wound abscess requiring operation, and one vesicovaginal fistula. Adhesions were present in all cases, endometriosis in 55% (35 out of 64), and fibrosis in 30% (19 out of 64).
CONCLUSION(S)
In experienced hands, laparoscopic treatment of OR results in acceptable outcomes with its associated advantages over laparotomy.
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