TITLE

Management of Ovarian Cysts in Women Undergoing Resorative Proctoclectomy for Ulcerative Colitis

AUTHOR(S)
Thakur, Anjani; Buchmiller-Crair, Terry; Fonkalsrud, Eric W.; Yang, Isaac; Lin, Albert
PUB. DATE
April 2003
SOURCE
American Surgeon;
SOURCE TYPE
DOC. TYPE
Article
ABSTRACT
More than half of all patients undergoing restorative proctocolectomy (RP) for ulcerative colitis (UC) are women, yet there is a paucity of information regarding the frequency, management, and outcome of ovarian cysts. A single surgeon's (E.W.F.) experience with female patients (N = 165) who underwent RP for UC at an academic medical center was retrospectively evaluated for postoperative complications and overall outcome. Patients with large ovarian cysts (LOCs), defined as being greater than 5 cm in diameter, were further segregated for subanalysis. All results were analyzed using the Student's t test and Fisher's exact test. Patients were 29.3 ± 13 years (mean) at the time of RP; 34 patients were less than 16 years old (21%), 113 patients (68%) were between the ages of 17 and 46 years, and 18 patients were over 46 years old (11%). All patients underwent total colectomy, mucosal proctectomy ileal pouch-anal anastomosis, and temporary end ileostomy. The ileostomy was closed 3 months later. Fifty-five of the 165 patients had ovarian cysts (33%) identified at operation, 46 had unilateral cysts, and nine had bilateral cysts. Mean ovarian cyst size was 4.6 ± 2.7 cm (range <1-13 cm); 14 were LOCs. Patients with cysts <3 cm in diameter at operation were treated by observation with hormonal manipulation. Seventeen patients with cysts 3 to 5 cm in diameter required partial resection of one or both ovaries. Six of 14 patients with LOC underwent unilateral oophorectomy (cyst size range 10-13 cm). Twelve patients presented within 3 years after RP with malfunction of the pouch because of adhesions or minimal and uncontrolled passage of fecal material (soiling), partial obstruction due to LOC compression of the ileoanal pouch (n = 6), or adhesions. When evaluated on the basis of ovarian cyst size those without cysts and those with small cysts were significantly more likely to have children than those with LOC: 54 of 110 patients without cysts (49%), 18 of the...
ACCESSION #
10544822

 

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