Factors that increase the risk of leakage during surgical removal of benign cystic teratomas

The contents of mature cystic teratomas can be a potent irritant resulting in chemical peritonitis, Using a retrospective cohort, we examined the vari ous risk factors for leakage of benign cystic teratomas during laparoscopy and laparotomy, Cyst leakage of the benign cystic teratoma contents was the primary endpoint. In all, 158 women underwent surgery for a total of 178 o varian benign cystic teratomas, Statistical analysis was performed using ch i(2), Mann-Whitney U and multivariate logistic regression analysis, A total of 115 benign cystic teratomas was successfully removed without intra-oper ative leakage and 63 underwent intraoperative leakage either at laparoscopy or laparotomy, The likelihood of success of removing the benign cystic ter atoma intact was unrelated to age, pre-operative size or surgical technique , There was no difference among cystectomies performed by laparotomy in sur geon experience or the presence of adhesions. However, surgeons with more l aparoscopic experience (>35 laparoscopies/year) were less likely to have in tra-operative leakage (relative risk: 0.5, 95% confidence interval: 0.2, 1. 2) compared to surgeons with less experience (<20/year) at cystectomy (26.1 versus 51.2% respectively), Oophorectomy significantly reduced the frequen cy of intra-operative leakage at both laparoscopy and laparotomy (14.7%), T hese findings suggest that laparoscopic experience can reduce the risk of l eakage at cystectomy, At laparotomy, lack of surgeon postgraduate years of experience was not a risk factor for leakage.