OVARIAN TRANSPOSITION BY LAPAROSCOPY BEFORE RADIOTHERAPY IN THE TREATMENT OF HODGKINS-DISEASE

BACKGROUND. The use of inverted Y irradiation in the treatment of Hodg kin's disease with pelvic lymph node involvement can cause iatrogenic early menopause in young women as a result of ovarian exposure to radi ation. Ovarian transposition protects the ovaries by removing them fro m the irradiation field. This surgical procedure, initially performed by laparotomy, can now be done by laparoscopy. METHODS. During the per iod July 1994 to April 1996, laparoscopic ovarian transposition was pe rformed on 4 young women with Hodgkin's disease 1 week before inverted Y radiotherapy. The surgical procedure, complications, length of hosp italization, and hormonal, clinical, and biologic results were evaluat ed. RESULTS. The mean duration of hospitalization was 4 days, and ther e were no postoperative complications. Iatrogenic menopause did not oc cur in any of the patients during the mean follow-up period of 20.75 m onths (range, 6-35 months; median, 20 months). CONCLUSIONS. Laparoscop y offers many advantages over laparotomy for ovarian transposition. Th is procedure, which can be performed without opening the abdominal wal l, is highly efficient, requires only a short period of hospitalizatio n, and leads to few postoperative complications. Laparoscopy is an att ractive alternative to laparotomy for ovarian transposition in young w omen with advanced Hodgkin's disease who require pelvic radiotherapy. Cancer 1998;83:1420-4. (C) 1998 American Cancer Society.