Local injection of various drugs for ovarian dermoid cysts at the time of laparoscopic ovarian cystectomy

In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2010 · vol. 26(2) , pp. 477–481 · doi:10.5180/jsgoe.26.477 · W2314311325
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Abstract

Recently, surgical treatments for gynecologic benign diseases have become minimally invasive. Thus, in our department, we perform laparoscopic surgery for all cases in which benign tumors are diagnosed, with the exception of cases that are too difficult to treat laparoscopically, such as size or suspected malignancy. We have reported before the efficacy of local infusion of vasopressin for endometrial and dermoid cysts. However, the use of vasopressin for vasocontraction is not indicated and has the possibility for severe complications. Herein we reviewed the cases in which laparoscopic ovarian cystectomies were performed for ovarian dermoid cysts, into non-drug, vasopressin, and epinephrine groups, and examined retrospectively about the age, diameter of tumors, haemorrhage, and operative time. We examined the cases in which laparoscopic ovarian cystectomies were performed for ovarian dermoid cysts in our hospital between January 2005 and March 2009. We performed ovarian cystectomies by using 100X diluted vasopressin or 1,000,000X diluted epinephrine, locally infused into a crevice of walls of ovarian cysts and normal ovarian tissues. There were no significant differences between the three groups in age, diameter of tumors, and operative times. Significant differences were shown with respect to haemorrhage (36.2 ±38.4 ml for the non-drug group, 3.4±6.3 ml for the vasopressin group, and 12.5±23.1 ml for the epinephrine group). More research will be necessary to reduce the haemorrhage equivalent to the use of vasopressin, by modifying the concentration of epinephrine. In the future, we will change the level of epinephrine administration, and it is thought that it is necessary to review whether or not there is an equal reduction in the hemorrhage effect with vasopressin.

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