Laparoscopic findings of Suspected Benign Adnexal Masses

Abstract

Objective To determine the percentage of various adnexal masses and to evaluate the feasibility,
safety, advantages and awareness associated with laparoscopic management in patients who
had suspected benign adnexal masses.
Design Retrospective study
Setting Endoscopic Unit of the Department of Obstetrics and Gynecology, Siriraj Hospital
Subjects Medical and laparoscopic surgical records of 292 patients with various clinical diagnoses,
who had suspected benign-adnexal masses and underwent laparoscopy from January 1998 to
December 2000
Results Patients ages ranged from 17 to 76 years, with a mean of 33.1±14.6 years. The most
common pre-operative diagnosis was endometriosis (54.1% of all the cases), 25.3% was other
benign ovarian tumors in which functional cyst was the most common (31.1%), endometrioma
was found in 23% of cases and 20.3% of cases had dermoid cyst. Overall, benign pathologic
conditions were found in 99.7% (291 / 292) of patients. The mean sizes of functional cyst,
other masses and neoplastic cyst were 3.1±2.3 cm, 3.9±3.0 cm, and 4.3 ±2.8 cm respectively.
The size of neoplastic cyst was significantly greater than non-neoplastic mass. Only one
malignant cyst was found in this study.
Conclusion Diagnostic laparoscopy to confirm the diagnosis and further management can be
performed in the same setting, with low rate morbidity and short hospital stay. Unless symptoms
are severe and acute, expectant management for 3 months of apparently benign ovarian tumor
does not seem to cause significant risks for the patients and may allow spontaneous regression
of functional cyst. Although laparoscopy is an microinvasive surgery, re-evaluation of the patient
just prior to surgery is a must.