Evaluation of immediate laparoscopic surgery for gynecologic disorders
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- Kanasaki, H., Oride, A., Nakayama, K. et al. Gynecol Surg (2012) 9: 111. doi:10.1007/s10397-011-0679-3
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The purpose of this study was to obtain information to aid in deciding the timing of immediate laparoscopic surgery for gynecological disorders. We evaluated immediate laparoscopic surgery (within 12 h after admission) performed at our institution between January 2005 and March 2010. Of the total 287 laparoscopic surgeries performed for patients with gynecological disorders during this period, 70 (24.4%) were immediate laparoscopic surgeries, 33 (47.1%) of which were for ectopic pregnancy, and 24 (34.3%) for ovarian tumor. Among the 24 surgeries for ovarian tumor, there were almost equal proportions of surgeries for mature cystic teratoma (ten cases, 41.7%) and endometrioma (nine cases, 37.5%). As to the breakdown of immediate surgery by pathology, immediate surgeries were performed in 20.8% of mature cystic teratoma cases and in 12.9% of endometrioma cases during this study period. In the 24 immediate surgeries for ovarian tumor, 10 cases (41.7%) had neither torsion nor rupture, 7 cases (29.2%) had torsion with mature cystic teratoma, serous cystadenoma or follicular cyst, and 7 cases (29.2%) had rupture of the tumor, all of which were endometrioma. Preoperatively, there were no significant differences between torsion and non-torsion cases in serum white blood cell (WBC) count or C-reactive protein (CRP) levels in peripheral blood. However, serum WBC and CRP levels tended to be elevated in cases of rupture with endometrioma. Especially in patients with ovarian tumor, presumed pathology is important in deciding the timing of immediate laparoscopic surgery.