Ovarian remnant syndrome: a retrospective evaluation of surgical management

In: Gynecological Surgery · 2016 · vol. 13(4) , pp. 353–357 · doi:10.1007/s10397-016-0988-7 · W2535064451
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This retrospective case series evaluated 17 patients with ovarian remnant syndrome, finding that surgical excision confirmed ovarian tissue, but recurrence was possible and treated non-surgically in three cases.

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This retrospective case series from a tertiary academic hospital evaluated 17 patients with ovarian remnant syndrome identified via diagnosis code search between 2005 and 2015, focusing on patient characteristics, operative findings, pathology, and recurrence after surgical management. All patients underwent surgical excision with pathology confirming ovarian tissue, and there were no intraoperative complications; excisions were mainly performed laparoscopically, and three recurrences were managed non-surgically. A key limitation is that the study is retrospective, single-institution, and based on a small cohort with recurrence treatment approaches not uniformly surgical. The paper relates to endometriosis because all patients had a history of endometriosis and the authors discuss ovarian remnant syndrome in this endometriosis-associated clinical context.

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Abstract

The objective of the study is to report on patient characteristics, surgical findings, pathology, and recurrence of ovarian remnants. This is a retrospective case series completed at an academic tertiary care hospital. Seventeen patients were identified between September 2005 and December 2015 with ovarian remnant syndrome using a diagnosis code search at one institution. All patients underwent surgical excision. Pathology confirmed ovarian tissue. Three recurrences were treated non-surgically. All patients had a history of endometriosis and previous surgeries. The average number of laparotomies, laparoscopies, and cesarean sections was 1.29 (range, 0–3), 2.47 (range, 0–6), and 0.59 (range, 0–3), respectively. Ten patients (58.8 %) had a prior bilateral salpingoophorectomy. Seven patients (41.2 %) had a prior unilateral salpingoophorectomy. Five patients (29.4 %) had one prior excision; two patients (11.8 %) had two prior excisions of their ovarian remnant. Fifteen excisions were performed laparoscopically and two with planned laparotomy. There were no intraoperative complications. All cases had pathologically confirmed ovarian tissue. Three patients had recurrent disease. Treatments included medical suppression, ovarian artery embolization, and radiation. Surgical expertise, often utilizing minimally invasive techniques, allows for the dissection needed to remove ovarian remnants. Recurrence is possible. Medical or other procedural treatments may be appropriate alternatives or adjuncts to treatment. Similar content being viewed by others

References

Shemwell RE, Weed JC (1970) Ovarian remnant syndrome. Obstet Gynecol 36:2990303 Nezhat C, Kearney S, Malik S, Nezhat C, Nezhat F (2005) Laparoscopic management of ovarian remnant. Fertil Steril 83:973–978 Arden D, Lee T (2010) Laparoscopic excision of ovarian remnants: retrospective cohort study with long-term follow-up. J Minim Invasive Gynecol 18:194–199 Magtibay PM, Magrina JF (2006) Ovarian remnant syndrome. Clin Obstet Gynecol 49:526–534 Webb MJ (1989) Ovarian remnant syndrome. Aust N Z J Osbstet Gynaecol 29:433–435 Haglund KE, Viswanathan AN (2008) Computed tomography-based radiation therapy of ovarian remnants for symptomatic persistent endometriosis. Obstet Gynecol 111(2 Pt 2):579–583 Kho RM, Abao MS (2012) Ovarian remnant syndrome: etiology, diagnosis, treatment and impact of endoemtriosis. Curr Opin Obstet Gynecol 24:210–214 Maleux G, Stockx L, Wilms F, Marchal G (2000) Ovarian vein embolization for the treatment of pelvic congestion syndrome: long-term technical and clinical results. J Vasc Interv Radiol 11(7):859–864 Acknowledgments Author contributions A Benton: project development, data collection, data analysis, and manuscript writing/editing. T Deimling: project development, data analysis, and manuscript writing/editing. M Pacis: project development and manuscript writing/editing. G Harkins: project development, data analysis, and manuscript writing/editing. Author information Authors and Affiliations Corresponding author Ethics declarations Funding This study had no source of funding. Conflict of interest The authors declare that they have no conflict of interest. Ethical approval An approval by an ethics committee was not applicable. Informed consent Informed consent was not applicable as determined by the Penn State Hershey Institutional Review Board. Rights and permissions About this article Cite this article Benton, A., Deimling, T., Pacis, M. et al. Ovarian remnant syndrome: a retrospective evaluation of surgical management. Gynecol Surg 13, 353–357 (2016). https://doi.org/10.1007/s10397-016-0988-7 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10397-016-0988-7

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