A study of cyst rupture rate by tissue type in open vs. laparoscopic surgery for ovarian tumor

摘要

Laparoscopy may be suitable for benign ovarian tumors, but the risk of intraoperative cyst rupture may carry serious consequences should the lesion prove cancerous postoperatively. Incidence of cyst rupture may be related to lesion tissue type; however, to our knowledge, no study to date has evaluated it by tissue type. We report herein a comparative retrospective study of open surgery and laparoscopy on cyst rupture by tissue type. A total of 1,483 cases of surgical removal of benign ovarian tumor performed at our institution between 1995 and 2010 were reviewed. Cyst rupture rates during open surgery and laparoscopy were compared for tumorectomy and adnexectomy for the four most frequent tissue types found at postoperative histopathology: endometrial cyst, mature cystic teratoma, serous cystadenoma, and mucinous cystadenoma. Data collected for our study demonstrated that cyst rupture rates are higher in laparoscopy than in open surgery regardless of tissue type. Rupture rates were significantly higher during laparoscopic tumorectomy, while there was no significant difference overall in rupture rate for open vs. laparoscopic adnexectomy. Laparoscopic procedures should be performed with utmost care to avoid cyst rapture when malignancy cannot be ruled out. A high risk of cyst rapture preoperatively expected by tissue type dictates an open surgery.