Laparoscopic management of adnexal masses: a gold standard?
| Autor: | C. Houlle, Gérard Mage, Benoit Rabischong, Arnaud Wattiez, Kris Jardon, Michel Canis, Revaz Botchorishvili, Antoine Safi, Jean Luc Pouly, Maurice Antoine Bruhat |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Prognostic factor medicine.medical_treatment Punctures Gynecologic Surgical Procedures Neoplasm Seeding Pregnancy Risk Factors Laparotomy medicine Humans Cyst Ovarian Neoplasms Ovarian Endometrioma medicine.diagnostic_test Rupture Spontaneous business.industry General surgery Epithelial carcinoma Gold standard Obstetrics and Gynecology Microsurgery medicine.disease Surgery Endoscopy Pregnancy Complications Ovarian Cysts Adnexal Diseases Female Laparoscopy Clinical Competence business |
| Zdroj: | Current opinion in obstetricsgynecology. 14(4) |
| ISSN: | 1040-872X |
| Popis: | Purpose of review To review recent literature on the laparoscopic management of adnexal masses, when this approach may be considered as a gold standard. Recent findings Cyst rupture was recently demonstrated to be a significant prognostic factor in stage I invasive epithelial carcinoma, and it was recommended to restrict the laparoscopic approach to patients with preoperative evidence that the cyst was benign. The laparoscopic approach is still highly controversial in masses suspicious at ultrasound. The limits of the laparoscopic approach are discussed reviewing recent literature and our experience. The laparoscopic management of adnexal masses appears to be safe in most hospitals even in developing countries. This approach is being used with increasing frequency in unusual indications such as newborns, children, adolescents and pregnant women. The learning curve for endoscopic surgery appears to be longer than expected. Many patients with benign adnexal masses, such as ovarian endometrioma, are still treated by laparotomy or with an inadequate endoscopic technique. Several studies have suggested that the stripping technique is a tissue-sparing procedure. Summary The laparoscopic puncture of malignant ovarian tumours confined to the ovaries is uncommon, and should be avoided whenever possible. The teaching of endoscopy is essential to promote adequate procedures performed according to the principles of microsurgery and to preserve postoperative ovarian physiology. |
| Databáze: | OpenAIRE |
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