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KMID : 0358420070500050789
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Korean Journal of Obstetrics and Gynecology
2007 Volume.50 No. 5 p.789 ~ p.795
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Laparoscopic adnexal surgery for posthysterectomy patients
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Lee Jung-Hun
Lee Hyo-Won
Kyung Min-Sun
Jung Un-Suk
Lee Kyo-Won
Han Jong-Sul
Choi Joong-Sub
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Abstract
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Objective: To evaluate the feasibility and effectiveness of laparoscopic adnexal surgery in posthysterectomy patients and review clinical characteristics including comparison of the adhesion score of left with that of right adnexal mass.
Methods: From February 2004 to January 2007, we reviewed the medical records of 23 post-hysterectomy patients who received laparoscopic adnexal surgery including age, parity, type of hysterectomy, operative indications, histopathological diagnosis, operating time, size of the adnexal mass, adhesion score, change in the hemoglobin level, hospital stay, and any complications.
Results: The median age of patients was 48 years (range 35-69 years), and median parity was 2 (0-3). The median operating time was 100 minutes (range 35-180 minutes), and the median size of the adnexal mass was 7.1 cm (range 4-12 cm). The median change in hemoglobin level was 1.8 g/dL (range 0.6-4.1 g/dL). The median hospital stay was 4 days (range 3-19 days). The adhesion score was significantly higher in the left adnexal mass than in the right adnexal mass. Histopathological diagnosis included 6 cases of mucinous cystadenoma, 6 cases of functional cyst, 4 cases of hydrosalpinx, 3 cases of serous cystadenoma, 1 case of fibrothecoma, 1 case of mucinous adenofibroma, 1 case of endometrioma, and 1 case of tubo-ovarian abscess. There were no intraoperative complications or conversion to laparotomy. One case of postoperative ileus was noted.
Conclusion: The skilled laparoscopic surgeon is capable of achieving successful result by performing laparoscopic surgery primarily to patients with adnexal mass for posthysterectomy patients who are expected to suffer severe adhesion. In posthysterectomy patients, left adnexal mass has more extensive adhesion than right adnexal mass, and these finding was represented as a high adhesion score of left adnexal mass.
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KEYWORD
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Laparoscopy, Adnexectomy, Hysterectomy
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