Human Reproduction, Vol 13, 324-329, Copyright © 1998 by Oxford University Press
C Chapron, JB Dubuisson, O Kadoch, S Capella-Allouc and MC Vacher-Lavenu
Only benign ovarian cysts can be treated by laparoscopic surgery. Although
clinical examination and the results of pre-operative work-up do make a
real contribution in indicating the benign or malignant nature of cysts,
only histology can provide the absolute diagnosis. In this context, the
goal of this study was to establish whether there is any advantage in
performing frozen section during laparoscopic surgical management of
organic ovarian cysts. Between January 1989 and March 1996, 228 patients
underwent an adnexectomy for an ovarian mass. After the pre-operative
work-up and the diagnostic phase of laparoscopy, 26 patients (11.4%)
presented with suspected signs of malignancy restricted purely to the
ovary. These 26 patients underwent a laparoscopic adnexectomy with
extraction of the excised tissues using an endoscopic bag, followed by
frozen section. For all these patients the results of the frozen section
concluded that the lesion was benign. In every case the definitive
histological results confirmed the frozen section findings. This strategy
enabled us to avoid laparotomy, especially for the nine post-menopausal
patients whose adnexal masses appeared to be complex by ultrasound. These
encouraging preliminary results need to be confirmed by a larger series of
patients, so as to specify the place of frozen section in the laparoscopic
surgical management of organic ovarian cysts.
ARTICLES
Laparoscopic management of organic ovarian cysts: is there a place for frozen section diagnosis?
Service de Chirurgie Gynecologique (Pr. Dubuisson), Clinique Universitaire Baudelocque, Paris, France.
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