In the past decade, use of minimally invasive surgery for removal of teratomas has increased significantly. However, there have been no studies performed in the United States comparing intra- and postoperative outcomes between minimally invasive removal and resection via laparotomy of adnexal teratomas.METHODS:
Chart review of cases of adnexal teratoma excision; 130 underwent minimally invasive removal and 25 underwent excision via laparotomy. Following data were collected: age, body mass index, ethnicity, existence of co-morbidities, adnexal cyst size, duration of surgery, estimated blood loss, length of hospital stay; incidence of cyst rupture, cyst recurrence and complications.RESULTS:
Body mass index was not significantly different between groups. Mean cyst diameter (10.5 cm vs 5.6 cm, P<.01), cyst recurrence rate (16% vs 1.6% P<.05), length of hospital stay (2.6 days vs 1 day, P<.01) and incidence of postoperative complications (8% vs 0.8%, P<.01) were significantly greater in women who underwent laparotomy than in women who underwent minimally invasive surgery. Estimated blood loss (43 mL vs 100 mL, P=.16), duration of surgery (1.9 hours vs 1.7 hours, P=.26) and incidence of cyst rupture (42% vs 52%, P=.33) were not significantly different between those undergoing minimally invasive surgery and those undergoing laparotomy.CONCLUSION:
Minimally invasive removal of teratomas is associated with a lower cyst recurrence and rupture rate, length of hospital stay postoperative complication rate than with excision via laparotomy. No cases of chemical peritonitis were identified.