Does tumor size limit application of laparoscopic surgery to ovarian tumors?

Abstract

Objective: We have found laparoscopic surgery to be both feasible and safe for large ovarian tumors, which at one time would have been managed strictly by conventional laparotomy. The aim of this study was to evaluate the potential risks and the outcomes of laparoscopic surgery for ovarian tumors on the basis of tumor size. Materials and methods: From among 1248 cases of adnexal tumor treated at our institution between June 2005 and June 2014, we identified 1196 cases of preoperatively diagnosed benign ovarian tumor treated by laparoscopic surgery. We divided the cases into three groups according to the diameter of the tumor: ≤ 5cm (Group A, n = 355), 6–9 cm (Group B, n = 688), and ≥10 cm (Group C, n = 153) and investigated the incidences of perioperative complications and the rates at which laparotomy was converted to open surgery. Results: Median operation time was 59 minutes, 7 minutes, and 73 minutes (p < 0.001) for Group A, Group B, and Group C, respectively. Median estimated blood loss was 7 mL, 16 mL, and 32 mL (p < 0.001), respectively. The perioperative complication rate (n = 4, n = 7, and n = 4, respectively), did not differ significantly between groups nor did the rate of conversion to laparotomy (n = 1, n = 2, and n = 2, respectively). Tumor size was not a prognostic indicator of perioperative complications (Hazard Ratio (HR), 0.96; 95% confidence interval, 0.79–1.16; p = 0.652). Conclusion: Operation time and estimated blood loss were shown to increase with the size of an ovarian tumor. However, we found no relation between tumor size and the perioperative complication rate or the rate of conversion to open surgery. Thus, we conclude that tumor size is not a factor limiting application of laparoscopic surgery to ovarian tumors.

Keywords

• complication
• laparoscopic surgery
• large ovarian tumor