Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

Abstract

Objective To evaluate whether the use of intraoperative ultrasound leads to more conservative surgeries for benign ovarian tumors.

Methods Women who underwent surgery between 2007 and 2017 for benign ovarian tumors were retrospectively analyzed. The women were classified into two groups: those who underwent intraoperative ultrasound (group A) and those who did not (group B). In group A, minimally-invasive surgery was performed for most patients (a specific laparoscopic ultrasound probe was used), and four patients were submitted to laparotomy (a linear ultrasound probe was used). The primary endpoint was ovarian sparing surgery (oophoroplasty).

Results Among the 82 cases identified, only 36 met the inclusion criteria for the present study. Out of these cases, 25 underwent intraoperative ultrasound, and 11 did not. There were no significant differences in arterial hypertension, diabetes, smoking history, and body mass index for the two groups (p = 0.450). Tumor diameter was also similar for both groups, ranging from 1 cm to 11 cm in group A and from 1.3 cm to 10 cm in group B (p = 0.594). Tumor histology confirmed mature teratomas for all of the cases in group B and for 68.0% of the cases in group A. When the intraoperative ultrasound was performed, a more conservative surgery was performed (p < 0.001).

Conclusion The use of intraoperative ultrasound resulted in more conservative surgeries for the resection of benign ovarian tumors at our center.

Resumo

Objetivo Avaliar se o uso do ultrassom intraoperatório leva a cirurgias mais conservadoras para tumores ovarianos benignos.

Métodos Mulheres que foram submetidas a cirurgia entre 2007 e 2017 por tumores ovarianos benignos foram analisadas retrospectivamente. As mulheres foram classificadas em dois grupos: aquelas que foram submetidas ao ultrassom intraoperatório (grupo A), e aquelas que não o foram (grupo B). No grupo A, foi realizada cirurgia minimamente invasiva na maioria das pacientes (foi usada sonda ultrassonográfica laparoscópica específica), e quatro pacientes foram submetidas a laparotomia (foi usada sonda ultrassonográfica linear). O desfecho primário foi a cirurgia preservadora do ovário (ooforoplastia).

Resultados Entre os 82 casos identificados, somente 36 atenderam aos critérios de inclusão para este estudo. Destes, 25 pacientes foram submetidas ao ultrassom intraoperatório, e 11 não o foram. Não houve diferenças significantes em relação à pressão arterial, diabetes, tabagismo e índice de massa corporal entre os dois grupos (p = 0.450). O diâmetro do tumor também foi similar entre os dois grupos, variando de 1 cm a 11cm no grupo A, e de 1,3 cm a 10 cm no grupo B (p = 0.594). A histologia dos tumores confirmou teratoma maduro para todos os casos do grupo B, e para 68,0% dos casos do grupo A. Mais cirurgias conservadoras foram realizadas quando o ultrassom intraoperatório foi realizado (p < 0.001).

Conclusão O uso do ultrassom intraoperatório resultou em mais cirurgias conservadoras na ressecção de tumores benignos do ovário em nossa instituição.

Keywords

intraoperative - laparoscopy - ovary - sparing - conservative surgery - ultrasound - oophoplasty

Palavras-chave

intraoperatório - laparoscopia - ovário - preservação - cirurgia conservadora - ultrassom - ooforoplastia

Contributors

All of the authors contributed to the development of the present research, helped in the conception, the design, the data interpretation, as well as in the critical review of the manuscript.

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