Endoscopic management of adnexal masses.

摘要: Background The laparoscopic management of suspicious adnexal masses and early ovarian malignancies is discussed with the aim maintaining accepted oncologic treatment principles. Comparative survival data patients gynecological managed by laparoscopy or laparotomy are still very scarce cancer must not be compromised new techniques. It time to closely analyze determine if it has a positive impact on diagnosis malignancies. In this paper we will address following points: 1) Which cysts can surgically treated (pelviscopy)? 2) Is staging an technique? 3) laparoscopy, as second-look procedure, benefit? 4) staging, together histologic tissue sampling, adequate surgical technique in inoperable ascites peritoneal carcinomatosis? 5) Does endoscopic biopsy stage Ia change destiny patient into Ic? Data base above questions analyzed based our experience 1,225 165 I IV immediately during years 1992-1995. Conclusions Ovarian cystic tumors no signs malignancy dealt means option immediate conversion within one week diagnosed. Today sampling lymphadenectomy both pelvic para-aortic feasible adequate. On curative level, number lymph nodes resected yet determined. adnexa extracted from abdominal cavity bag extraction without danger spillage. uterus removed transvaginally assisted vaginal hysterectomy (LAVH). We cautious advocate for cancer. However, excellent tool when used procedure. A careful preoperative screening exact definition existing imaging techniques allows us frequently apply surgery cysts, leaving only readily detectable cases laparotomy. Many oncologists employing procedures agree that initiating case may preclude many patients. Tumor propagation performing FIGO does occur receives radical week. According reports Sevelda et al. Dembo al., degree differentiation existence more relevant decreasing five-year rate than rupture capsule penetration tumor. dependency first two parameters was found these large statistical studies. As question operations mass predominantly put sanitation small (ovarian solid particles section primary laparotomies) there remains wide field indications benign indications. For young non-malignant lesions such endometriosis, proliferations fibromas, avoided laparoscopy.