C Chapron1, J B Dubuisson, S Capella-Allouc. 1. Service de chirurgie Gyncologique, Clinique Universitaire Baudelocque, C.H.U. Cochin Port-Royal, Paris, France.
Abstract
OBJECTIVES: The aim of the study is to specify the place, modalities and results of operative laparoscopy when adnexectomy is indicated in a patient presenting with an adnexal mass. STUDY DESIGN: A retrospective analysis of the 186 patients who underwent adnexectomy for an adnexal mass between January 1, 1989 and December 31, 1994. RESULTS: The operation took place via laparotomy in 34.9% of cases (65 patients) and by laparoscopic surgery in 65.1% of cases (121 patients). All the patients presenting a malignant ovarian lesion (15 cases) were operated by laparotomy. For these patients the laparotomy was decided from the outset in 7 cases and there was a conversion to laparotomy decided during the diagnostic phase of laparoscopy in 8 cases. The preoperative workup (clinical examination, study of past history, trans vaginal ultrasonography, doppler, tumoral markers etc.) together with the diagnostic phase of laparoscopy provide 100% sensitivity, a positive predictive value of 50% and a negative predictive value of 100% for diagnosis of malignancy. CONCLUSION: These results demonstrate that provided a strict selection system is used, it is possible to carry out adnexectomy using laparoscopic surgery in 70.8% of cases (121/171) for patients with benign adnexal mass.
OBJECTIVES: The aim of the study is to specify the place, modalities and results of operative laparoscopy when adnexectomy is indicated in a patient presenting with an adnexal mass. STUDY DESIGN: A retrospective analysis of the 186 patients who underwent adnexectomy for an adnexal mass between January 1, 1989 and December 31, 1994. RESULTS: The operation took place via laparotomy in 34.9% of cases (65 patients) and by laparoscopic surgery in 65.1% of cases (121 patients). All the patients presenting a malignant ovarian lesion (15 cases) were operated by laparotomy. For these patients the laparotomy was decided from the outset in 7 cases and there was a conversion to laparotomy decided during the diagnostic phase of laparoscopy in 8 cases. The preoperative workup (clinical examination, study of past history, trans vaginal ultrasonography, doppler, tumoral markers etc.) together with the diagnostic phase of laparoscopy provide 100% sensitivity, a positive predictive value of 50% and a negative predictive value of 100% for diagnosis of malignancy. CONCLUSION: These results demonstrate that provided a strict selection system is used, it is possible to carry out adnexectomy using laparoscopic surgery in 70.8% of cases (121/171) for patients with benign adnexal mass.