Conversion of laparoscopy to laparotomy due to adenxal malignancy

G. Biran, A. Golan, R. Sagiv, M. Glezerman, J. Menczer

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. The purpose of the present report was to assess the conversion rate from laparoscopy to laparotomy due to adenxal malignancy and to identify factors that might assist in the selection of the appropriate operative approach in patients with suspicious adenxal masses. Methods. A retrospective review of the medical records of women who underwent laparoscopy due to ultrasonically complex adenxal masses. Ninety-five consecutive patients fulfilling these criteria, were identified. A comparison of patients with benign tumors who had laparoscopy only to those with invasive malignancies in whom laparoscopy was converted to laparotomy was performed. Results. Malignancy was diagnosed in 18 (18.9%) patients. In 13 patients with malignancy (two borderline and 11 invasive), comprising 72.2% of the malignancies and 13.7% of the total group with complex adenxal masses, the laparoscopy was converted to laparotomy. Age of more than 50 years and a serum CA125 level above 35 U/ml were significantly more common in the malignant than in the benign group (90.9% vs. 15.6% and 63.6% vs. 11.6%, respectively; p < 0.0001 and p < 0.003, respectively). When both factors were present, the sensitivity and specificity for malignancy were 73.3% and 93.2%, respectively, and the positive and negative predictive values 73.3% and 95.6%, respectively. Conclusion. When an ultrasonically complex adenxal mass is encountered, predictive factors for malignancy should be taken into account before the mode of intervention is chosen. The conversion from laparoscopy to laparotomy because of an invasive malignant tumor is acceptable, if it is performed immediately and a gynecologic oncologist is on stand-by.

Original languageEnglish
Pages (from-to)157-160
Number of pages4
JournalEuropean Journal of Gynaecological Oncology
Volume23
Issue number2
StatePublished - 2002
Externally publishedYes

Keywords

  • Adenxal malignancy
  • Complex adenxal masses
  • Conversion to laparotomy
  • Laparoscopy

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