Laparoscopic treatment of ovarian dermoid cysts Ppt Powerpoint Presentation slides TSIKOURAS PANAGIOTIS Medical Slideshow dermoid cyst Hutchinson encyclopedia article about dermoid cyst

Laparoscopic treatment of ovarian dermoid cysts

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Slide 1 :

Laparoscopic treatment of ovarian dermoid cysts P.Tsikouras1, V.Liberis1 , G.Galazios1 , A.Savidis1 ,S.Zervoudis 4 , T.Vogiatzaki 3, A.T.Teichmann 2 and G.Maroulis1 Department of Obstetrics and Gynecology Democritus University of Thrace, Greece1. Department of Obstetrics and Gynecology Aschaffenburg 2 . Department of Anaesthesiology Democritus University of Thrace, Greece 3 Lito Maternity Hospital & ATEI University of Athens, Greece 4

Slide 2 :

Summary Dermoid cysts, are the most common germ cell tumours of the ovary in women of reproductive age. We report 67 cases of patients with dermoid cysts (mean age, 31.31 years) originating from the ovary treated from 1994 to 2006 at the obstetrical and gynaecological department of Obstetric-Gynecology of Aschaffenburg –Hospital in Germany. Most patients ( 60) underwent cystremoval. In 2 patients adnexectomy was performed and in 5 we performed partial oophorectomy. Two patients were 9 and 15 weeks pregnant and postoperative had well following termination of pregnancy. In a group of 43 women ,who were known to desire pregnancy , 37 pregnancies were resulted. The overall intrauterine pregnancy rate was 83.7%; one patient had an ectopic pregnancy (2.32%). To receive more information on this disease, treatment should be performed according to international protocols.

Slide 3 :

Introduction Dermoid cyst accounts for 21.8% of all ovarian tumours.(1) Benign or mature cystic teratomas (MCT), also known as dermoid cysts, are composed of mature tissues, which can contain elements of all three germ cell layers. Typically they contain mature tissues of ectodermal (skin, brain), mesodermal (muscle, fat), and endodermal (mucinous or ciliated epithelium) origin. In monodermal teratomas, one of these tissue types (e.g., thyroid tissue in struma ovarii, neuroectodermal tissue in carcinoid tumour) predominates. Benign ovarian tumours affect all age groups, while malignant tumours are more frequent among elderly women.( 2) Dermoid cysts are recognised as one of the most common tumours in women during the reproductive years.(3 ) The period of maximum incidence of these tumours is between 30 and 40 years of age.(4 ,5)

Slide 4 :

Introduction In approximately 10-15% of cases, the tumours present on both sides. ( 6) Several primordial can appear in one single ovary. Benign cystic teratomas are the most frequent ovarian tumours discovered during pregnancy (24-40%). (7 ) Ninety-nine percent of teratomas are benign Malignant transformation occurs in approximately 1 % of cases.( 8-10) Squamous cell carcinoma is the most commonly associated malignancy, though any constituent can undergo malignant change giving rise to a variety of tumours ( 8,11 ). Adenocarcinoma and the carcinoid form are much less frequent(12).

Slide 5 :

Introduction The tumours often grow slowly and cause minimal symptoms until very large, or there are complications dermoid cysts. Usually dermoids cysts are slow growing ,even in premenopausal women. They are usually asymptomatic until they reach considerable size. The clinical course of dermoid cysts of the ovary is asymptomatic and torsion or spontaneous rupture (followed by acute chemical peritonitis) only occur in 16% and 3–7% of patients, respectively ( 13) Diagnosis is based on clinical examination and ultrasonographic indications, confirmed by radiological evidence of solid cystic residues in the ovaries (14) Ovarian dermoid cysts are relatively frequent ovarian lesions that can be easily diagnosed by transvaginal ultrasonography. Endovaginal ultrasound with Doppler enhancement is the best imaging technique to establish the nature of cysts and to distinguish cysts suspicious for malignancy which require more invasive investigation. MRI and endovaginal sonogram appear to be useful tools in the pre-operative selection for this surgery. Tumour markers are definitely indicated for postmenopausal patients whereas they appear less useful in young patients.

Slide 6 :

Introduction With adequate pre-operative selection, both conservative and minimally invasive surgery can be applied with a clear benefit for the patient. Pelvic laparoscopy is the surgical approach of choice for the treatment of non-functional benign ovarian cysts Dermoid cysts are benign tumours affecting young patients that can derive benefits from conservative and minimally invasive surgery. Conservative treatment to shell out the cyst and preserve functional ovarian tissue should be reserved for women desirous of future pregnancies. The surgical management of germ cell tumours of the ovary is based on the premise of preserving fertility. Ovarian germ cell tumours occur in young women in whom fertility preservation is of great concern. In the recent years, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. Cystectomies with preservation of the ovarian remnant should be the routine surgical treatment of benign cystic teratomas. Laparoscopic surgery has almost totally replaced laparotomy in the management of benign adnexal conditions. We retrospectively reviewed the outcome of laparoscopic surgery for ovarian dermoid cysts, complications, and postoperative follow-up

Slide 7 :

Material and Method Charts of 67 patients who underwent laparoscopic removal of dermoid cysts since March 1994 until October 2006 at the Department of Obstetric-Gynecology of Aschaffenburg –Hospital in Germany were reviewed retrospectively. All the patients had pre-operative CA-125 antigen evaluation and transvaginal sonography with Doppler assessment of the ovarian pathology. Transvaginal sonography was carried out by one of the investigators ,using a 5-6.5 MHz transducer Reliability of the recordings was usually confirmed by a single trained clinician and in difficult cases a second opinion was sought from one of the consultants involved in the study The sonographic characteristics as well as the expected histological diagnosis were evaluated pre-operatively. An inhomogeneous mass with irregular hypoechoic and hyperechoic areas with posterior shadowing not separated by septa, or a homogeneous hyperechoic mass with regular capsule and posterior shadowing was categorised as a typical dermoid cyst. (15) This diagnosis was compared with the histopathological diagnosis All the women with tumours less than 12 cm in diameter were qualified for laparoscopic management. Laparoscopy was conducted under general anaesthesia.

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	ptsikour@med.duth.gr 1 Years ago. Category: Obstetrics and Gynecology

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PowerPoint Presentation on Laparoscopic treatment of ovarian dermoid cysts or PowerPoint Presenta more PowerPoint Presentation on Laparoscopic treatment of ovarian dermoid cysts or PowerPoint Presentation on Dermoid cysts, are the most common germ cell tumours of the ovary in women of reproductive age. We report 67 cases of patients with dermoid cysts (mean age, 31.31 years) originating from the ovary treated from 1994 to 2006 at the obstetrical and gynaecological department of Obstetric-Gynecology of Aschaffenburg –Hospital in Germany. Most patients ( 60) underwent cystremoval. In 2 patients adnexectomy was performed and in 5 we performed partial oophorectomy. Two patients were 9 and 15 weeks pregnant and postoperative had well following termination of pregnancy. In a group of 43 women ,who were known to desire pregnancy , 37 pregnancies were resulted. The overall intrauterine pregnancy rate was 83.7%; one patient had an ectopic pregnancy (2.32%). To receive more information on this disease, treatment should be performed according to international protocols. less