Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (BOT)

Journal of Ovarian Research

Sven Mahner³  Fritz Jaenicke³  Matthias Choschzick¹  Donata Grimm³  Linn Woelber³  Ulrike Doerste²  Uwe Herwig²  Jan David Ruetzel³  Fabian Trillsch³ 

[1] Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Department Gynecology and Obstetrics, Albertinen-Krankenhaus, Hamburg, Germany;Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany

关键词: Laparotomy;    Laparoscopy;    Morbidity;    Complications;    Surgical management;    Borderline ovarian tumor;   

Others  :  810308
DOI  :  10.1186/1757-2215-6-48

 received in 2013-05-11, accepted in 2013-06-29,  发布年份 2013

【 摘 要 】

Background

Surgery is the cornerstone for clinical management of patients with borderline ovarian tumors (BOT). As these patients have an excellent overall prognosis, perioperative morbidity is the critical point for decision making when the treatment strategy is developed and the primary surgical approach is defined.

Methods

Clinical and surgical parameters of patients undergoing surgery for primary BOT at our institutions between 1993 and 2008 were analyzed with regard to perioperative morbidity depending on the surgical approach (laparotomy vs. laparoscopy).

Results

A total of 105 patients were analyzed (44 with primary laparoscopy [42%], 61 with primary laparotomy [58%]). Complete surgical staging was achieved in 33 patients at primary surgical approach (31.4%) frequently leading to formal indication of re-staging procedures. Tumor rupture was significantly more frequent during laparoscopy compared to laparotomy (29.5% vs. 13.1%, p = 0.038) but no other intraoperative complications were seen in laparoscopic surgery in contrast to 7 of 61 laparotomies (0% vs. 11.5%, p = 0.020). Postoperative complication rates were similar in both groups (19.7% vs. 18.2%, p = 0.848).

Conclusions

Irrespective of the surgical approach, surgical management of BOT has acceptable rates of perioperative complications and morbidity. Choice of initial surgical approach can therefore be made independent of complication-concerns. As the recently published large retrospective AGO ROBOT study observed similar oncologic outcome for both approaches, laparoscopy can be considered for staging of patients with BOT if this appears feasible. An algorithm for the surgical management of BOT patients has been developed.

【 授权许可】

   
2013 Trillsch et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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