Laparoscopic Management of Giant Ovarian Cysts at the Gynecology and Obstetrics Department of Ouakam Military Hospital (Senegal)

Abstract

Objectives: To remind the epidemiology, the diagnosis and the surgical aspects of laparoscopic management of giant ovarian cysts at the Gynecology and Obstetrics Department of Ouakam Military Hospital.Materials and methods: This is a prospective and descriptive study carried out during 2 years, from February 1st 2015 to January 31st 2017 at the Gynecology and Obstetrics Department of Ouakam Military Hospital. It involved all patients who had undergone laparoscopic surgery for an ovarian cyst which measures 15 cm or more. The parameters studied were the patient's socio-demographic characteristics, the clinical symptomatology, ultrasound and/or CT scan results, surgical data, the histological nature of the cyst and the length of hospital stay. Data was captured and analyzed by Excel.Results: Patients' age ranged from 13 to 41 years with an average of 27.1 years. Physical examination had shown an abdominal mass in all patients. Imaging examinations (ultrasound and/or CT scan) found an ovarian cystic mass that varied in size from 15 to 27 cm with an average of 20 cm. Only one patient (9.1%) had a rate of CA 125 above the threshold. Laparoscopy confirmed the diagnosis of all patients. We performed 9 cystectomies (81.8%) and 2 adnexectomies (18.2%). The procedure lasted in average 72 min with extremes of 50 and 90 min. The surgical follow-up was simple and the discharge was authorized 3 days after surgery. The histological examination of the surgical specimens performed in all patients revealed 3 serous cystadenomas (27.3%), 3 dermoid cysts (27.3%), 3 endometriomas (27.3%) and 2 mucinous cystadenomas (18.2%).Conclusion: Laparoscopy should be indicated to treat giant ovarian cysts. Ultrasound and CT scan allow making good selection of cases for this approach.