Laparoscopic Surgery in Elderly Patients Aged 65 Years and Older with Gynecologic Disease

Objectives. The study was conducted to characterize the use of the laparoscopic surgery in elderly patients. Methods. The medical records of elderly patients aged ≥65 years who underwent laparoscopic surgery were retrospectively reviewed for diseases, surgical procedures, histological diagnosis, intraoperative and postoperative complications, and reasons for presentation. Results. Of the 405 patients who underwent laparoscopic surgery between January 2005 and March 2012, 41 (10.1%) were aged ≥65 years. The most common disease treated by surgery was ovarian tumor, followed by uterine prolapse. Histological diagnosis of ovarian tumor specimens obtained from 23 patients included serous cystadenoma (44.0%), mature cystic teratoma (20.0%), mucinous cystadenoma (20.0%), and endometrioma (4%). In contrast, in the non-elderly group, the most common histological diagnosis was endometrioma (42.9%), followed in order by mature cystic teratoma (28.3%), serous cystadenoma (18.0%), and mucinous cystadenoma (4.7%). While 23.7% of the non-elderly patients required emergency laparoscopic surgery, none of the elderly patients required emergency surgery. Only 1 of 27 patients who underwent surgery for an ovarian or adnexal mass presented with abdominal pain. No one developed serious intraoperative or postoperative complications. Conclusion. Laparoscopic surgery can be safely performed in elderly patients. It should be noted, however, that few elderly patients with benign pelvic mass manifest symptoms before undergoing surgery.

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Minimally Invasive Surgery at Paropakar Maternity and Women’s Hospital

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v12i2.19943 ◽

2018 ◽

Vol 12 (2) ◽

pp. 16-20

Author(s):

Gehanath Baral ◽

Rijuta Joshi

Keyword(s):

Laparoscopic Surgery ◽

Minimally Invasive ◽

Hospital Stay ◽

Histopathological Examination ◽

Mucinous Cystadenoma ◽

Cystic Teratoma ◽

Laparoscopic Hysterectomy ◽

Serous Cystadenoma ◽

Cross Sectional ◽

Benign Condition

Aims: The purpose of this study is to review the reintroduced minimally invasive surgical practice in the hospital after a couple of decades long gap. Methods: It is a two years (2015 to 2017) retrospective cross-sectional study carried out in Paropakar Maternity and Women’s Hospital. The patients with pre-operative diagnosis of benign condition underwent laparoscopic surgery; hysteroscopy was diagnostic and operative both. Data were collected by demographics, indication of surgery, nature of surgery, complications, hospital stay and histo-pathological reports. Data were entered in the SPSS and MS-excel. Results were presented as tables and graphs.Results: Sixty five and 39 women underwent laparoscopic surgery and hysteroscopy respectively. None of them had major complications and hospital stay was1-3 days in majority. The most common age group was 31-35 years. Preoperative diagnoses of them were adnexal tumor in 47 women, fibroid uterus in six, AUB in two, ectopic pregnancies in four, PCOD in two and one women each with primary sub-fertility and POP Q II with elongated cervix. Laparoscopic cystectomy was performed on 25 women for the adnexal masses while 13 women underwent laparoscopic oophorectomy for the ovarian masses. Total laparoscopic hysterectomy was the second commonest surgery (n=12). On histopathological examination of the ovarian tissues, mature cystic teratoma was the commonest finding (n=18) followed by the endometriotic cysts (n=9), benign serous cystadenoma (n=7) and mucinous cystadenoma (n=4). Conclusions: Laparoscopy and hysteroscopy procedures have become the alternative in surgical modality at this hospital.

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Collision Tumors in Ovary: Case Series and Literature Review

Journal of Surgical Oncology ◽

10.31487/j.jso.2019.03.06 ◽

2019 ◽

pp. 1-10

Author(s):

Borges A ◽

Loddo A ◽

Martins A ◽

Peiretti M ◽

Fanni D ◽

...

Keyword(s):

Literature Review ◽

Ovarian Tumor ◽

Case Series ◽

Mucinous Cystadenoma ◽

Cystic Teratoma ◽

Mature Cystic Teratoma ◽

Adequate Treatment ◽

Collision Tumors ◽

Brenner Tumor ◽

Malignant Lesions

Histologically distinct tumors that coexist in an organ without any histological admixture at their interface are denominated collision tumors. We report 3 cases of colliding mature cystic teratoma with mucinous cystadenoma and a case of mature cystic teratoma colliding with benign Brenner tumor in the ovary. We also provide a literature review based on 35 previously published ovarian collision cases. Ovarian tumors from all classes, benign, borderline and malignant lesions may collide. Both our case series and the literature review indicate that ovarian tumor collisions tend to be clinically and ultrasonographically/radiologically unrecognized. The awareness among surgeons, radiologists and pathologists of this rare phenomenon and histological recognition are crucial in order to offer adequate treatment to patients. There is a need to identify novel and more specific imaging clues pointing towards collision tumors in the ovary.

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Clinico-pathological profile of ovarian cysts in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174456 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4642 ◽

Cited By ~ 1

Author(s):

Sairem Mangolnganbi Chanu ◽

Biswajit Dey ◽

Vandana Raphael ◽

Subrat Panda ◽

Yookarin Khonglah

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Lower Abdominal Pain ◽

Cystic Teratoma ◽

Serous Cystadenoma ◽

Mature Cystic Teratoma ◽

Ovarian Cysts ◽

Histopathological Diagnosis ◽

Care Hospital ◽

North East

Background: Ovarian cystic neoplasms are common in gynaecological practice. These may pose diagnostic difficulty to the pathologists. This study was conducted to analyse the clinical and histological profile of ovarian cystic neoplasms.Methods: This is a retrospective study done from January 2016 to April 2017 in a tertiary care hospital in North East India. All the patients, who were clinically and radiologically diagnosed as ovarian cysts, which had histopathological confirmation were included in the study. Data including the age, parity, clinical symptoms, laterality and histopathological findings were analysed.Results: A total of 101 patients operated for ovarian cysts in the study period were analysed. The most common clinical presentation was lower abdominal pain. There were 11 (10.9%) malignant cases, 4 (4%) were intermediate grade and borderline in nature, and 85 (84.1%) cases were benign in nature. There was 1 (1%) case of metastasis to ovary. Mature cystic teratoma was most common (20.8%) histopathological diagnosis. The second most common cyst was serous cystadenoma (19.8%).Conclusion: Ovarian cysts are commonly encountered in gynaecological practice and equally encountered by the pathologists. Most commonly found ovarian cysts were mature cystic teratoma followed by serous cystadenoma.

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Short‐ And medium‐term outcomes of reduced‐port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study

Cancer Medicine ◽

10.1002/cam4.3070 ◽

2020 ◽

Vol 9 (15) ◽

pp. 5320-5326

Author(s):

Huawen Wu ◽

Zhijian Zheng ◽

Lewei Xu ◽

Yingying Wu ◽

Ziyi Guan ◽

...

Keyword(s):

Rectal Cancer ◽

Cohort Study ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Medium Term ◽

Reduced Port ◽

Surgery In Elderly

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Laparoendoscopic single-site versus conventional laparoscopic surgery for ovarian mature cystic teratoma

Obstetrics & Gynecology Science ◽

10.5468/ogs.2015.58.4.294 ◽

2015 ◽

Vol 58 (4) ◽

pp. 294 ◽

Cited By ~ 5

Author(s):

Jeong-Yeol Park ◽

Dae-Yeon Kim ◽

Dae-Shik Suh ◽

Jong-Hyeok Kim ◽

Joo-Hyun Nam

Keyword(s):

Laparoscopic Surgery ◽

Cystic Teratoma ◽

Mature Cystic Teratoma ◽

Single Site ◽

Conventional Laparoscopic Surgery ◽

Conventional Laparoscopic ◽

Laparoendoscopic Single Site ◽

Site Versus

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Pseudomyxoma Peritonei Associated With a Mucinous Ovarian Tumor Arising From a Mature Cystic Teratoma. A Case Report

International Journal of Gynecological Pathology ◽

10.1097/01.pgp.0000209571.16340.20 ◽

2006 ◽

Vol 25 (4) ◽

pp. 340-343 ◽

Cited By ~ 12

Author(s):

Sophie Marquette ◽

Frederic Amant ◽

Ignace Vergote ◽

Philippe Moerman

Keyword(s):

Case Report ◽

Pseudomyxoma Peritonei ◽

Ovarian Tumor ◽

Cystic Teratoma ◽

Mature Cystic Teratoma

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Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer

Annals of Coloproctology ◽

10.3393/ac.2019.10.03 ◽

2020 ◽

Vol 36 (4) ◽

pp. 229-242 ◽

Cited By ~ 1

Author(s):

Hyun Hee Kim ◽

Myong Hoon Ihn ◽

Yun Hee Lee ◽

Jihyoun Lee ◽

Sangchul Yun ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Adverse Events ◽

Elderly Patients ◽

Chemotherapy Regimen ◽

Postoperative Chemotherapy ◽

Smoking History ◽

Curative Intent ◽

Physical Status Classification

Purpose: We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.Methods: Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.Results: Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).Conclusion: This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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