A MULTICENTER STUDY OF LAPAROSCOPIC MANAGEMENT OF SELECTED CYSTIC ADNEXAL MASSES IN POSTMENOPAUSAL WOMEN

BACKGROUND: The objective of this study was to determine the ability t o predict benign adnexal masses in postmenopausal women and to evaluat e the effectiveness of laparoscopic management in selected patients. S TUDY DESIGN: Postmenopausal women found to have an adnexal mass were p rospectively evaluated with clinical examination, sonography, and seru m CA-125 levels. Women with cystic masses greater than 3 cm but less t han 10 cm, with distinct borders, without solid parts or septations gr eater than 2 mm, without ascites or matted bowel, and with serum CA-12 5 levels less than 35 IU per mL were operated upon by laparoscopy. RES ULTS Sixty-one women gave consent for the study. Cyst size ranged from 3 to 10 cm. All masses were accurately predicted to be benign. Fifty- eight (95 percent) women were successfully managed by operative laparo scopy and three required laparotomy. For the patients managed by lapar oscopy, the mean operative time was 63 minutes, the mean postoperative hospitalization period was 12 hours, and the mean return to normal ac tivity was 5.6 days. CONCLUSIONS: The combination of clinical examinat ion, sonographic appearance and serum CA-125 levels can accurately pre dict benign masses in postmenopausal women. Operative laparoscopy is a cceptable for these patients and provides for a short period of hospit alization and a rapid recovery.