Clinical Characteristics of 30 Cases of Laparoscopic Surgery for Ovarian Cysts in Second Trimester

  Objective  To investigate the characteristics of laparoscopic surgery for ovarian cysts in second trimester.

  Methods  Between April 2002 and December 2013, 30 patients were treated with laparoscopic surgery for clinically suspected ovarian cyst in second trimester at Department of Obstetrics and Gynecology, Peking Union Medical College Hospital. Clinical data of these patients were reviewed for identification of clinical characteristics, and assessment of feasibility and indications of the surgery.

  Results  Of the 30 patients, the mean age was (28.5±3.1) years, gestational age was (14.7±2.5) weeks, mean operation time was (50±20)minutes, and mean length of hospital stay was (4.5±0.8)days. Between the patients with gestational age ≥ 16 weeks (11/30, 36.7%) and those with gestational age < 16 week (19/30, 63.3%), no difference was noted in operation time (P>0.05). In the 30 patients, only 5 (16.7%) patients had known about the ovarian masses before pregnancy. The mean diameter of the masses was (9.0±5.4) cm. In the 12 patients (40%) who had masses with diameter ≥ 9 cm, the operation time was significantly longer than that in the 18 patients (60%) who had masses < 9 cm (P < 0.05). Five patients (16.7%) received emergency surgery, including 2 cases (6.7%) receiving simple salpingo-oophorectomy for ovarian necrosis due to adnexal torsion. In the other 28 patients(93.3%), the ovary cysts were removed. Postoperative pathological examination showed teratoma in 18 cases (60%), serous cyst in 6 cases (20%), corpus luteum cyst in 3 cases (10%), mucinous cystadenoma in 2 cases (6.7%), and foam fibroma in 1 case (3.3%). One patient (3.3%) experienced postoperative contractions, which were cured by magnesium sulfate and progestin. No severe complications occurred. Twenty-six(86.7%) patients delivered healthy full-term infants, and the other 4 (13.3%) cases lost to follow-up.

  Conclusions  Laparoscopic surgery is a safe and feasible procedure for the treatment of ovarian cysts in second trimester of pregnancy. For adnexal masses persistent or suspicious for torsion, surgical management is warranted. Close maternal and fetal monitoring is essential during and after the operation.