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Ishikawa H, Shozu M. Modified Leak-Proof Puncture Technique for the Aspiration of Giant Ovarian Cysts by Instantly Mounting a Plastic Wrap and Gauze with Cyanoacrylates: A Retrospective Observational Study. Front Surg 2022; 9:948073. [PMID: 35865035 PMCID: PMC9295911 DOI: 10.3389/fsurg.2022.948073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveWe developed a leak-proof puncture technique for giant ovarian cysts by instantly mounting a plastic wrap to the cysts using cyanoacrylates and aspirating cyst fluid over the wrap. Here, we modified it by inserting a gauze between the wrap and cyst to strengthen the mounting. This study aimed to clarify the feasibility of the modified procedure.MethodA retrospective observational study was conducted in a single center. Surgical outcomes of 35 women who underwent the modified procedure from December 2013 to July 2020 were compared with those of 51 women who underwent the original procedure.ResultsMean long-axis diameters of the cysts were 233.1 mm and 229.8 mm in the modified and original procedures, respectively. The median of surgical time, blood loss, and aspirated fluid volume were 109 min, 50 ml, and 3,050 ml, in the modified procedure, all of which were not significantly different from those of the original procedure. One case of mounting disruption and two (5.7%) cases of intraperitoneal spillage of the cyst fluid were observed in the modified procedure, whereas four (7.8%) cases of mounting disruption and five (9.8%) cases of intraperitoneal spillage occurred in the original procedure. These events were caused by aspiration difficulty of the high viscosity fluid and/or multilocular cysts. Laparotomy conversion was observed in five (14.3%) cases in the modified procedure.ConclusionOur modified procedure is feasible in select cases. The high viscosity of the cyst fluid and multilocular cyst may cause mounting disruption and intraperitoneal spillage of the cyst fluid.
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Seo M, Choi MHDORESMHCOMTCUOKSROKCSICESMHCOMTCUOKSROK, Lee YJ, Jung SE, Rha SE. Evaluating the added benefit of CT texture analysis on conventional CT analysis to differentiate benign ovarian cysts. Diagn Interv Radiol 2021; 27:460-468. [PMID: 34313229 DOI: 10.5152/dir.2021.20225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the benefit of adding CT texture analysis on conventional CT features of benign adnexal cystic lesions, especially in identifying mucinous cystadenoma. METHODS This retrospective study included patients who underwent surgical removal of benign ovarian cysts (44 mucinous cystadenomas, 32 serous cystadenomas, 16 follicular/simple cysts and 43 endometriotic cysts) at our institution between January 2015 and November 2017. The CT images were independently reviewed by an abdominal radiologist (reviewer 1) and a resident (reviewer 2). Both reviewers recorded the conventional characteristics and performed texture analysis. Based on reviewer 1's results, two decision trees for differential diagnosis were developed. Reviewer 2's results were then applied to the decision trees. The diagnostic performances of each reviewer with and without the decision trees were compared. RESULTS Several conventional features and texture analysis parameters showed significant differences between mucinous cystadenomas and other benign adnexal cysts. The first decision tree selected septum number and thickness as significant features, whereas the second decision tree selected septum number and the mean values at spatial scaling factor (SSF) 0. Reviewer 1's performance did not change significantly with or without the use of the decision trees. Reviewer 2's interpretations were significantly less sensitive than reviewer 1's interpretations (p = 0.001). However, when aided by the first and second decision trees, Reviewer 2's interpretations were significantly more sensitive than reviewer 1's interpretations (86.4%, p < 0.001; 72.7%, p = 0.001). CONCLUSION This study suggests the benefit of CT texture analysis on conventional images to differentiate mucinous cystadenoma from other benign adnexal cysts, particularly for less experienced radiologists.
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Affiliation(s)
- Minkook Seo
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Moon Hyung Department Of Radiology Eunpyeong St Mary's Hospital College Of Medicine The Catholic University Of Korea Seoul Republic Of Korea Catholic Smart Imaging Center Eunpyeong St Mary's Hospital College Of Medicine The Catholic University Of Korea Seoul Republic Of Korea Choi
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea;Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Young Joon Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Eun Jung
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea;Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
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Wolfman W, Thurston J, Yeung G, Glanc P. Directive clinique no 404 : Évaluation initiale et prise en charge des masses ovariennes bénignes. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:1051-1062.e1. [DOI: 10.1016/j.jogc.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gaballah KM, Habeeb RM, Abdallah SI. Efficacy of intraperitoneal bupivacaine, hydrocortisone, and magnesium sulfate in different combinations for pain relief after laparoscopic ovarian cystectomy: a double-blind randomized controlled trial. Minerva Anestesiol 2020; 86:14-22. [DOI: 10.23736/s0375-9393.19.13550-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ki EY, Park EK, Jeong IC, Bak SE, Hwang HS, Chung YH, Song MJ. Laparoendoscopic Single Site Surgery for the Treatment of Huge Ovarian Cysts Using an Angiocatheter Needle. Yonsei Med J 2019; 60:864-869. [PMID: 31433584 PMCID: PMC6704019 DOI: 10.3349/ymj.2019.60.9.864] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/14/2019] [Accepted: 07/05/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the feasibility and safety of laparoendoscopic single site (LESS) surgery using an angiocatheter needle in patients with huge ovarian cysts (diameter ≥15 cm). MATERIALS AND METHODS Thirty-one patients with huge ovarian cysts underwent LESS surgery using an angiocatheter needle between March 2011 and August 2016. An intra-umbilical vertical incision (1.5-2.0 cm) was made in the midline. After the cyst wall was punctured using an angiocatheter needle, the fluid contents were aspirated with a connected vacuum aspirator. After placing a Glove port in the umbilical incision, LESS surgery was performed using a rigid 0-degree, 5-mm laparoscope and conventional, rigid, straight laparoscopic instruments. Knife-in-bag morcellation was instituted for specimen collection. RESULTS The median maximal diameter of ovarian cysts was 18 cm (range, 15-30 cm), the median operation time was 150 minutes (range, 80-520 minutes), and the median volume of blood loss was 100 mL (range, 20-800 mL). Three patients (9.7%) were diagnosed with malignant ovarian cancer using intraoperative frozen examination, and 1 patient was converted to laparotomy due to advanced disease. Thirty patients underwent LESS, and there was no need for an additional laparoscopic port. CONCLUSION LESS surgery using an angiocatheter needle, with leaving only a small postoperative scar, was deemed feasible for the management of huge ovarian cysts.
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Affiliation(s)
- Eun Young Ki
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Eun Kyung Park
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - In Cheol Jeong
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Sung Eun Bak
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Hye Sung Hwang
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Yoo Hyun Chung
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Min Jong Song
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
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Öge T, Öztürk E, Yalçın ÖT. Does size matter? Retrospective analysis of large gynecologic tumors. J Turk Ger Gynecol Assoc 2017; 18:195-199. [PMID: 29278233 PMCID: PMC5776159 DOI: 10.4274/jtgga.2017.0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/01/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate the characteristics of patients who underwent surgery due to the presence of a large pelvic-abdominal mass over a 5-year period in a university clinic. MATERIAL AND METHODS Among 3476 gynecologic operations, intraoperative findings were evaluated retrospectively. Uterine and/or adnexal masses smaller than 20 cm were excluded to refine "large" tumors and 74 patients with large tumors were enrolled in the study group. Demographic characteristics, intraoperative findings, and results of histopathologic examinations were recorded. Moreover, preoperative and intraoperative findings were compared among tumors with adnexal origin according to their final histopathologic results. RESULTS The mean age of the patients was 46 years. The most common symptom was abdominal pain, as recorded in 38 (51.4%) patients. Among all patients, 31 (41.9%) had coexisting illness and 13 (17.6%) had a history of surgery. The mean tumor diameter was 25.9±8.6 cm (20-60) and 60 (78.9%) tumors were of adnexal origin. The ratios of malignancy for large adnexal and uterine tumors were 34.4% and 12.5%, respectively. When the large adnexal tumors were re-evaluated, the mean cancer antigen (CA) 125 level was significantly higher, and ascites was more frequently detected in malignant tumors (p<0.01) then in benign and borderline tumors. CONCLUSION Benign and borderline tumors are more common among large abdominopelvic masses, although the presence of ascites and elevated CA 125 may present malignancy in large gynecologic tumors. Further studies with larger sample sizes are needed to define the characteristics of large tumors and their malignant potentials.
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Affiliation(s)
- Tufan Öge
- Department of Obstetrics and Gynecology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Emel Öztürk
- Clinic of Obstetrics and Gynecology, Beyhekim State Hospital, Konya, Turkey
| | - Ömer T. Yalçın
- Department of Obstetrics and Gynecology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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Diop B, Niang MM, Ba PA, Toure PS, Sy A, Wane Y, Sarre SM. Management of Giant Ovarian Cysts: A Review of 5 Case Reports. J Gynecol Surg 2016. [DOI: 10.1089/gyn.2015.0057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Balla Diop
- Department of Surgery, Military Hospital of Ouakam, Dakar, Senegal
- UFR Santé, University of Thies, Thies, Senegal
| | | | - Pape Abdoulaye Ba
- Department of General Surgery, Regional Hospital Center of Thies, Thies, Senegal
| | | | - Abdou Sy
- Department of Surgery, Military Hospital of Ouakam, Dakar, Senegal
| | - Youhanidou Wane
- Department of Surgery, Military Hospital of Ouakam, Dakar, Senegal
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