LAPAROSCOPIC MANAGEMENT OF OVARIAN-TUMORS

Background: Laparoscopy can be used with minimal operative morbidity t o evaluate adnexal masses. We report our experience with the endoscopi c approach to the diagnosis and treatment of ovarian tumors. In partic ular, we describe 11 patients who incidentally underwent laparoscopy a nd in whom the ovarian masses were found to be malignant. Methods: Bet ween September 1994 and September 1996, 292 patients with 316 ovarian tumors were treated laparoscopically in the Department of Obstetrics-G ynaecology, University of Ulm. We assessed vaginal ultrasonography, cl inical assessment, the tumor marker CA 12-5, and the intraoperative lo w-power magnification for their value in predicting the final diagnosi s in all laparoscopically treated ovarian tumors. Results: From a tota l of 292 patients with ovarian tumors, 11 were diagnosed, intraoperati vely or after final histologic examination, as having a malignant or b orderline ovarian tumor, All applied pre- and intraoperative diagnosti c procedures were by themselves too unreliable to exclude early stages of ovarian carcinoma exactly. Conclusions: On the basis of the presen t findings, we are tempted to conclude that laparoscopic surgery is ju stified in the management of ovarian tumors, Even with an accurate pre operative selection of suitable patients for laparoscopic surgery, the presence of an undetected ovarian carcinoma cannot be entirely exclud ed.