Combined Ultrasonographically Guided Drainage and Laparoscopic Excision of Large Endometriomas

G G Garzetti, Giuseppe Gioele Garzetti, A Ciavattini, Andrea Ciavattini, Mauro Tiriduzzi, M Tiriduzzi
Gynecologic and obstetric investigation · 1998 · vol. 45(4) , pp. 266–268 · doi:10.1159/000009981 · PMID:9623794 · W2067479858
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This prospective pilot study demonstrated that pre-operative GnRH analogue treatment followed by ultrasonographically guided drainage and laparoscopic excision is a feasible approach for large ovarian endometriomas.

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Abstract

We report a prospective pilot study which evaluated the feasibility of combined ultrasonographically guided drainage and laparoscopic excision after pre-operative administration of a gonadotrophin-releasing hormone analogue for 3 months in the management of ovarian endometriotic cysts >5 cm. Ten patients with an ultrasonographic diagnosis of large unilateral or bilateral ovarian endometriotic cysts received an intramuscular injection of leuprorelinum acetate 3.75 every 4 weeks for 12 weeks. After 4 weeks of medical treatment, the endometrioma was carefully drained transabdominally under ultrasonographic control. Within 8 weeks since the last injection, the patients were submitted to a second ultrasonography, and laparoscopy-guided stripping of the endometrioma was performed. A videotape review was undertaken to evaluate duration and complexity of the different phases of surgery. Stripping of endometriomas with preservation of residual ovarian parenchymas was obtained in all cases; adhesiolysis was complete in 6 cases. There were neither intra-operative complications nor conversions in laparotomy. In conclusion, gonadotrophin-releasing hormone analogue and cyst drainage seem to permit an easy laparoscopic approach of large endometriomas; the findings of our pilot phase seem to justify a randomized trial to better define the effectiveness of this approach with respect to standard procedures.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Drainage Endometriosis Endometriosis Laparoscopy Adult Drainage Endometriosis Feasibility Studies Female Humans Leuprolide Leuprolide Ovarian Cysts Ovarian Cysts Ovarian Cysts Ovarian Cysts Pilot Projects Prospective Studies Ultrasonography

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