Laparoscopic surgery in ovarian and paraovarian cysts

Abstract

Aim: In this comparative study, we retrospectively evaluated ovarian and paraovarian cysts. Patients and Methods: Thirty-four children with ovarian and paraovarian cysts were evaluated according to age, clinical and imaging findings, treatment modality, lenght of hospital stay (LOS) and complications. Cysts less than 5 cm were not operated. Patients diagnosed as intrauterine ovarian and paraovarian cysts were evaluated after birth. Detorsion was performed in patients with torsion. The gonads were preserved excepting cases with marked ovarian necrosis. Cysts were evacuated, and their epithelium was peeled off. Results: The median age of the patients was 13 years (3 days-17 years). Ultrasonography and abdominal CT revealed cysts more than 5 mm or torsioned cysts in all patients but two. Each patient with acute abdomen and abdominal mass underwent laparoscopy without any finding at imaging modality. Twenty-two patients were operated laparoscopically, and 12 with open surgery. We detected ovarian/tubal torsion in 17, ovarian cysts in 12, paraovarian cysts in 4, concomittant ovarian and retroperitoneal cysts in 1 patient, respectively. The largest diameters of the cysts were 6-30 cm. Oopherectomy was performed in 7 patients. Each one patient had prolonged ileus and intraoperative bleeding. No further complication was seen. One patient with open surgery had a mature cystic teratoma, whereas all other patients had simple cysts. The mean duration of lapa-roscopic surgery (TOS) was significantly decreased (Open surgery 88.1±13.3 min and laparoscopic surgery 72.8±13.5 min) (p<0.05). Although there was no significant difference between open and laparoscopic surgery with respect to the length of hospital stay (LOS) and onset of oral intake and other complications (superficial surgical site infection, postoperative fever and pain), the mean LOS (open surgery 3.33 days and laparoscopic surgery 2.69 days) and TOS of the patients with laparoscopic surgery was shorter. Conclusion: Laparoscopic surgery is effective and safe in children with ovarian and paraovarian cysts with a shorter postoperative LOS and TOS.