Laparoscopic stripping of endometriomas: a randomized trial on different surgical techniques. Part II: pathological results

Ludovico Muzii; Filippo Bellati; Antonella Bianchi; Innocenza Palaia; Natalina Manci; Marzio Angelo Zullo; Roberto Angioli; Pierluigi Benedetti Panici
July 2005
Human Reproduction;Jul2005, Vol. 20 Issue 7, p1987
Academic Journal
BACKGROUND: The stripping technique for endometriomas excision has been reported to be associated with follicular loss. The objective of this trial was to evaluate the presence and nature of ovarian tissue adjacent to the endometrioma cyst wall obtained by stripping with different techniques. METHODS: Forty-eight patients with ovarian endometrioma were enrolled in two consecutive independent randomized trials. Two different techniques were analysed at the initial adhesion site (circular excision and subsequent stripping versus immediate stripping). Two different techniques were analysed at the ovarian hilus (stripping versus coagulation and cutting). Histology analysis was performed in three portions of the cyst wall (initial adhesion site, intermediate part of the specimen, ovarian hilus). RESULTS: Recognizable ovarian tissue was inadvertently excised together with the endometrioma cyst wall in most cases. At initial adhesion sites more ovarian tissue was removed with the circular excision technique (<0.001). No significant difference in quality of ovarian tissue (number and type of follicles) was found between specimens obtained with different surgical techniques at the initial or at the final part of the procedure. At the initial adhesion site and at the intermediate part of the cyst wall, the ovarian tissue removed along with the endometrioma wall was mainly constituted by tissue with no follicles or only primordial follicles (60% and 48% of the specimens from the initial part with both techniques, and from the intermediate part, respectively, had no follicles or only primordial follicles). Close to the ovarian hilus the ovarian tissue removed along with the endometrioma wall mostly consisted of tissue which contained primary and secondary follicles (69% of the cases, combining the two groups). CONCLUSIONS: Ovarian tissue is inadvertently excised together with the endometrioma wall in most cases. The excised tissue is at normal functional development stages only near the ovarian hilus. The different techniques used do not influence significantly the quality of the resected tissue.


Related Articles

  • Cholangiocarcinoma Complicating Primary Sclerosing Cholangitis: A 24-Year Experience. Morris-Stiff, G.; Bhati, C.; Olliff, S.; Hübscher, S.; Gunson, B.; Mayer, D.; Mirza, D.; Buckels, J.; Bramhall, S. R. // Digestive Surgery;2008, Vol. 25 Issue 2, p126 

    Aim: To report the prevalence and outcome of cholangiocarcinoma arising in primary sclerosing cholangitis for a British tertiary referral centre. Methods: All patients diagnosed with primary sclerosing cholangitis and concurrent cholangiocarcinoma were identified from a prospectively maintained...

  • Laparoscopic excision of a giant mesothelial omental cyst. Deshpande, Aparna A.; Dalvi, Abhay N. // Journal of Minimal Access Surgery;Apr-Jun2012, Vol. 8 Issue 2, p57 

    A 42-year-old patient presented with right-sided abdominal discomfort. Investigations revealed a 19 × 21 centimetres large cystic lesion occupying nearly the entire right side of the abdomen. It was situated between ascending colon and right kidney and extended from the liver to the pelvic...

  • Laparoscopic Left Lateral Liver Sectionectomy: A Safe, Efficient, Reproducible Technique. Abu Hilal, M.; Pearce, N. W. // Digestive Surgery;2008, Vol. 25 Issue 4, p305 

    Background: Laparoscopic left lateral sectionectomy (LLLS) is procedure with potential for future transformation into a primarily laparoscopic procedure where surgeons can safely develop laparoscopic experience and gain proficiency. Methods: Between August 2004 and December 2007, 80 patients...

  • Laparoscopic excision of duodenal schwannoma. Orsenigo, E.; Di Palo, S.; Vignali, A.; Staudacher, C. // Surgical Endoscopy;Aug2007, Vol. 21 Issue 8, p1454 

    Background: Benign duodenal tumours are rare and less common than malignant tumours. They comprise a wide variety of pathologies. Schwannoma is an ectodermal neoplasm arising from the nerve sheath that envelops axons. A duodenal location is extremely rare. Therapy consists in the...

  • Left Pancreatectomy for Neuroendocrine Pancreatic Tumors. Milanetto, A. C.; Moletta, L.; Lico, V.; Sperti, S.; Pedrazzoli, S.; Pasquali, C. // Neuroendocrinology;Jul2012 Supplement, Vol. 96, p49 

    Introduction: Distal pancreatectomy for neuroendocrine tumors localized in the body-tail of the pancreas (NTP) can be performed either with splenectomy (DP) or with a spleen-preserving procedure (SPLP). Aim(s): To retrospectively evaluate postoperative complications and clinical outcome of...

  • Thoracoscopic resection of esophageal duplication cysts. Herbella, F. A. M.; Tedesco, P.; Muthusamy, R.; Patti, M. G. // Diseases of the Esophagus;Apr2006, Vol. 19 Issue 2, p132 

    Esophageal duplication is a rare congenital esophageal disorder. Surgical excision is the standard treatment for symptomatic esophageal duplication cysts. Traditionally, the resection is accomplished via thoracotomy; however, a minimally invasive approach is possible, avoiding the long hospital...

  • Acute ruptured esophageal duplication cyst. Neo, Eu Ling; Watson, David I.; Bessell, Justin R. // Diseases of the Esophagus;May2004, Vol. 17 Issue 1, p109 

    A 32-year-old man presented acutely with a ruptured esohageal duplication cyst. This is a rare complication from an unusual congenital condition. The case describes his clinical presentation, radiological investigation and surgical management. The pathology of the excised specimen is described...

  • Bartholin’s Gland Hyperplasia in a Young Woman. Ben-Harosh, Shani; Cohen, Itzhak; Bornstein, Jacob // Gynecologic & Obstetric Investigation;Jan2008, Vol. 65 Issue 1, p18 

    Background: Tumors arising from the Bartholin’s gland are very rare; the majority are benign. As most instances of swelling in the Bartholin’s gland area represent a duct cyst, clinicians tend to perform incision and drainage, rather than excision of the tumor. Case: A young woman...

  • Lumbar Intradural Extramedullary Bronchiogenic Cyst. Chongyi, S.; Meng, Y.; Dejun, Y.; Yingjie, L.; Qingpeng, L. // European Surgical Research;2008, Vol. 40 Issue 1, p26 

    The pathological findings of an intradural and extramedullary cyst at the L1 level of the spinal canal are described in a 28-year-old male who presented with chronic lumbago and progressive weakness and numbness in both lower limbs. Histopathological examination revealed the diagnosis of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics