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Laparoscopic Management of Benign Adnexal Cysts - Efficacy and Safety of Procedure Orginal Article
Author(s) Name:
Nasira Tasnim, Kauser Tasnim Bangash, Kauser Masoom, Amna Abbasi
Address of Correspondence
Prof. Nasira Tasnim, Professor and Head of Unit II ,MCH center, Shaheed Zulfiqar Ali Bhutto Medical University ,Pakistan Institute of Medical Science (SZABMU-PIMS), Islamabad
 
ABSTRACT

Objective: to evaluate safety and efficacy of laparoscopy in the management of benign adnexal cysts presenting in a tertiary care hospital.
Study design: prospective cross sectional study.
Place and Duration: MCH center, Pakistan institute of medical sciences from 1st July 2012 to 31st June 2014
Methodology: During 2 years period, 117 Pre-menopausal women with benign adnexal cyst of 4-10 cm size underwent laparoscopy for the purpose to treat. Laparoscopic procedure was performed after thorough evaluation, using standard technique .A predesigned structured study performa was filled for each case. Analysis was done through SPSS version 11.At the end of 2 years, cases were analyzed in terms of completeness of procedure through laparoscopy alone assessed and complication rate. 
Results: among 117 adnexal cysts, 113(96.5 %) were Ovarian while the rest were Para ovarian. Serous cyst adenoma was the most common pathology in 52(46%), followed by endometriotic cysts in 42 (37%) cases. Majority were unilateral cysts (98%). Of 117 cases, 109 (93%) were successfully managed through laparoscope while 8 (7%) required conversion laparotomy due to inseparable intestinal adhesion in 5, technical difficulties in 2 and mesenteric vascular injury in 01 case. Mean postoperative hospital stay was 3 days. Post-operative course was uneventful in all except one patient with dermoid cyst who required laparotomy on 5th post op day due to severe chemical peritonitis. No mortality was reported.
Conclusion: laparoscopic procedure is safe and effective option for the treatment of benign adnexal cyst of ≤ 10 cm size. Proper selection of cases, experienced surgical team and well equipped setup are the key factors in achieving optimum results.
Keywords: laparoscopy, ovarian cystectomy, adnexal mass, laparoscopic ovarian cystectomy.

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