Zhao J, et al. - Physicians designed this study to examine the short-term outcomes and pregnancy rate after a laparoscopic approach to fertility preservation in patients with borderline ovarian tumors (BOTs). In incomplete surgery patients who underwent complete exploration, a comprehensive laparoscopic surgery was not performed. They observed good short-term outcomes and pregnancy in patients receiving conservative laparoscopic surgery for BOTs. This was particularly seen in patients receiving incomplete conservative laparoscopic surgery.

Methods

• Researchers retrospectively examined clinic-pathologic variants of patients with BOTs who underwent conservative surgery at the Tianjin Central Hospital of Obstetrics and Gynecology between January 2009 and July 2015.

Results

• Seventy-four patients (35.1%) received conservative surgery among 211 patients with BOTs (44 cases using a laparoscopic approach and 30 cases using a laparotomy approach).
• For the laparotomy group, the mean age was significantly younger than that of the laparoscopic group (P=0.024).
• The maximal longitude of the tumor was significantly longer in the laparotomy group than that in the laparoscopic group (P < 0.001).
• In the laparoscopic group, the number of incomplete surgery cases was significantly greater compared to the laparotomy group (P < 0.001).
• No significant differences were noted in gravidity and parity before surgery, abnormality of serum tumor makers, tumor lateralities, ascites, histology, duration of follow-up, pregnancy rate after surgery, or postoperative recurrence between the 2 groups.
• In this study, total recurrent rate was 6.7% (5/74).
• In laparotomy group and in laparoscopic group, 2 cases and 3 cases relapsed respectively.
• No significant difference of recurrent rate was noted between the 2 groups.
• The total pregnant rate was 33.8% (25/74).
• During follow-up, 9 patients (30%) in the laparotomy group and 16 patients (36.4%) in the laparoscopic group became pregnant respectively.
• Between 2 groups, there were no significant differences in the postoperative durations of pregnancy, pregnancy type, age at pregnancy, tumor lateralities, ascites, or type of pathology.
• In laparoscopic group, the pregnancy rate of incomplete surgery cases was significantly higher than that of laparotomy group (P=0.011).
• Among the pregnant cases, no recurrence occurred.