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[Safety and effectiveness of endosurgical management of benign adnexal tumors in the premenopausal period: a prospective study].

Between January 1985 and December 1989, a prospective laparoscopic study was performed in premenopausal women with pelvic cysts growing or persisting for at least three months or evoking acute abdominal complaints. The aim of this prospective study was the investigation of the functional/nonfunctional rate, the relapse and the malignancy rate. 372 women underwent a diagnostic-operative laparoscopy in the absence of irregular solid and cystic parts detectable by preoperative vaginal ultrasonography. The treatment consisted of non-randomised endosurgical ovarian cystostomy, cystectomy or ovarectomy. Histopathological assessment showed functional ovarian cysts in 268 women and non-functional benign ovarian tumours in 104. 2 cases were subsequently found to be malignant. After a mean follow-up-time of at least one year, we found an overall recurrence rate of 4.6% after cystostomy, 2% after cystectomy and 0% after ovarectomy in the group of functional ovarian cysts and a total of 1% after endosurgical therapy of the non-functional ovarian tumours. The diagnostic operative laparoscopy proved to be a safe and efficient treatment of pelvic cysts in women of reproductive age, provided a sufficient preoperative vaginal ultrasound examination had been performed.