Recurrence of chocolate cysts after laparoscopic ablation

Jones KD, K D Jones, Kevin Jones, Chris Sutton, C J G Sutton, Sutton CJ
The Journal of the American Association of Gynecologic Laparoscopists · 2002 · vol. 9(3) , pp. 315–320 · doi:10.1016/s1074-3804(05)60410-0 · PMID:12101328 · W2129791794
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This paper investigates the recurrence rate of chocolate cysts following laparoscopic ablation in a cohort of patients.

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Abstract

STUDY OBJECTIVE: To estimate the recurrence rate of chocolate cysts 3 to 12 months after ablative laparoscopic surgery. The secondary outcome measure was the need for a repeat surgical procedure. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Tertiary referral center for laparoscopic treatment of endometriosis. PATIENTS: Seventy-three consecutive women with chocolate cysts larger than 2 cm. INTERVENTION: Laparoscopy at which cyst capsules were vaporized or coagulated with the potassium-titanyl-phosphate (KTP) laser or Bicap bipolar diathermy. MEASUREMENTS AND MAIN RESULTS: There were 96 cysts (23 bilateral) in 73 women (1 patient underwent a two-stage procedure). Their mean diameter was 4.79 cm (range 2-25 cm). The median r-AFS score was 56 (range 22-128), and 55 patients (75.3%) had stage 4 disease. The KTP laser was used in 50 women (68.5%) and bipolar diathermy in 23 (31.5%). At 12 months, 5 patients (6.9%) were lost to follow-up, and 12 had a recurrent cyst. Therefore, the cyst recurrence rate/patient was 16.4% (12/73) and the rate/cyst was 12.5% (12/96). Women who had recurrences were significantly more likely to have bilateral cysts, 7/12 (58.3%), than those with single cysts, 16/61 (26.2%, p =0.032). Bicap bipolar diathermy was associated with a recurrence rate of 20.8% (5/24). The rate in women who had KTP laser ablation was 14.3% (7/49, NS). Eighteen patients had repeat operations (including on recurrent cysts). Therefore the reoperation rate was 24.6% (18/73). No major surgical complications occurred. One woman had a postoperative wound infection after a second procedure to remove an ovary with a recurrent cyst. CONCLUSION: Laparoscopic cyst fenestration followed by capsule ablation is safe and effective treatment for preventing recurrence of chocolate cysts.

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Condition tags

endometriosis

MeSH descriptors

Catheter Ablation Catheter Ablation Laparoscopy Laparoscopy Ovarian Cysts Ovary Adult Adult Endometriosis Endometriosis Endometriosis Female Female Humans Humans Ovarian Cysts Ovarian Cysts Ovarian Cysts Ovarian Diseases Ovarian Diseases

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Cited by (29)

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