Laparoscopic management of large ovarian tumors: clinical tips for overcoming common concerns

AIM: This study was performed to assess the feasibility and efficacy of laparoscopic management for patients with large ovarian tumors. MATERIAL AND METHODS: A retrospective analysis was performed of the medical records of 52 women who underwent laparoscopic surgery for large ovarian tumors whose maximum diameter was ≥15cm and a low possibility of malignancy. RESULTS: The median age of patients was 35years (range 18-84), median body mass index was 22.4kg/m(2) (range 12.4-31.5) and 18 patients had previous operative history. The median tumor diameter was 17cm (range 15-40). There were no conversions to laparotomy and perioperative complications. The median operating time, estimated blood loss, and hospital stay were 80min (range 25-225), 100mL (range 50-500) and 3days (range 2-14), respectively. The operative procedures performed were salpingo-oophorectomy (n=26), ovarian cystectomy (n=16), laparoscopically assisted vaginal hysterectomy with unilateral or bilateral salpingo-oophorectomy (n=9), and laparoscopically assisted staging surgery (n=1). The histopathological results were mucinous cystadenoma (n=25), mature cystic teratoma (n=9), serous cystadenoma (n=6), endometrioma (n=5), mucinous borderline tumor (n=4), follicular cyst (n=2), and clear cell carcinoma (n=1). CONCLUSION: Laparoscopic management of large ovarian tumors is feasible and efficient with appropriate patient selection and experience of surgeons.