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- Title
Surgical treatment of mature cystic teratomas: A comparison of emergent and elective surgeries.
- Authors
Ganer Herman, Hadas; Sagiv, Ron; Raphaeli, Hagit; Kerner, Ram; Keidar, Ran; Bar, Jacob; Ginath, Shimon
- Abstract
Aim To compare patient characteristics, imaging and surgical management of mature cystic teratomas (MCTs) according to surgery type - elective versus emergent. Methods The study included surgeries performed between 1990 and 2016, during which histologically verified ovarian MCT material was obtained. The elective management group included surgeries performed at a pre-set date or incidental finding of MCT as part of a different surgery. Emergent surgeries were considered as such if performed as a result of suspected adnexal torsion. Results One hundred ninety two operations in which MCT was confirmed by histology were included: 136 elective, 56 emergent. The majority (88.5%) of study patients were of reproductive age. Patients in the emergent surgery group were significantly younger (27.5 ± 10.2 vs 36 ± 13.8 years, P < 0.001). Sensitivity for dermoid diagnosis was significantly increased among elective surgery patients (65.2% vs. 47.1%, P = 0.02). Laparoscopy was the preferred surgical mode in both study groups. Adnexal torsion was confirmed in 67.8% of emergent surgeries. Conservative surgery, including cystectomy with or without detorsion, was more commonly performed in emergent surgeries (91% vs. 72.7%, P = 0.006). Bilateral salpingo-oophorectomy with or without total abdominal hysterectomy was more commonly performed in elective surgery patients (22% vs. 3.5%, P = 0.001). Patient parity, mass size and white blood cell count were independently associated with adnexal torsion. Conclusions Adnexal torsion is common among symptomatic patients with MCT and is related to mass size, patient age, past parity and white blood cell count. Most patients with MCT are of reproductive age and thus are treated with a minimally invasive approach.
- Subjects
AGE distribution; COMPARATIVE studies; HYSTERECTOMY; LAPAROSCOPIC surgery; MEDICAL emergencies; OVARIECTOMY; PROBABILITY theory; ELECTIVE surgery; TERATOMA; PARITY (Obstetrics); TORSION abnormality (Anatomy); DERMOID cysts; DATA analysis software; DESCRIPTIVE statistics; CYSTECTOMY; LEUKOCYTE count; SALPINGECTOMY
- Publication
Journal of Obstetrics & Gynaecology Research, 2017, Vol 43, Issue 1, p190
- ISSN
1341-8076
- Publication type
Article
- DOI
10.1111/jog.13190