LAPAROSCOPIC OVARIAN TRANSPOSITION FOR PELVIC MALIGNANCIES - INDICATIONS AND FUNCTIONAL OUTCOMES

Objective: To assess the indications and effectiveness of laparoscopic ovarian transposition before pelvic irradiation for a gynecologic can cer. Design: Prospective study. Setting: A gynecologic oncology depart ment in a French anti-cancer center. Patient(s): Twenty-four patients treated for pelvic cancer. Intervention(s): Laparoscopic ovarian trans position to paracolic gutters. Uterine conservation in 18 patients. Ma in Outcome Measure(s): Clinical and laboratory follow-up tests of ovar ian function. Result(s): Bilateral laparoscopic ovarian transposition was achieved in 22 patients (94%). Twelve patients were treated for cl ear cell adenocarcinoma of the cervix and/or upper vagina, 6 patients for invasive squamous cervical carcinoma, 3 patients for pelvic sarcom a, 1 patient for recurrent cervical cancer to the upper vagina, 1 pati ent for ependymoma of the cauda equina, and 1 patient for ovarian dysg erminoma. Ovarian preservation was achieved in 79%. Three pregnancies were obtained. Conclusion(s): Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. Bilatera l ovarian transposition should be performed. The main indications for laparoscopic ovarian transposition are a patient with a small invasive cervical carcinoma (<2 cm) in a patient <40 years of age who is treat ed by initial laparoscopically assisted vaginal radical hysterectomy a nd a patient with a clear cell adenocarcinoma of the cervix and upper vagina. (Fertil Steril(R) 1998;70:956-60 (C) 1998 by American Society for Reproductive Medicine.).