The Utility and Feasibility of Laparoscopic Surgery in Patients Diagnosed With Cervical Cystic Lesions

TL;DR

This study explores how laparoscopic surgery can help diagnose and treat cervical cystic lesions, showing it is both feasible and effective.

Contribution

The study demonstrates the utility of laparoscopic surgery in differentiating benign and malignant cervical cystic lesions preoperatively.

Findings

Laparoscopic surgery provided diagnostic clarity and therapeutic benefits for cervical cystic lesions.

Malignant cases had longer surgical times and higher blood loss compared to benign cases.

No postoperative recurrence was observed in malignancy cases despite diagnostic challenges.

Abstract

Introduction: This observation study aimed to differentiate between lobular endocervical glandular hyperplasia (LEGH) and gastric-type mucinous carcinoma (GAS) while evaluating the feasibility and efficacy of laparoscopic surgery in the preoperative diagnosis of cervical cystic lesions.

Method and Material: A retrospective study was conducted to evaluate the diagnostic process and laparoscopic surgical management of cervical cystic lesions suspected to be LEGH or GAS. Preoperatively and postoperatively, MRI, cytology, histology, tumor marker analysis, and surgical outcomes (blood loss during surgery, operative time) were assessed. Six individuals were selected based on magnetic resonance imaging (MRI) results indicating a preoperative suspicion of LEGH or GAS. These patients underwent laparoscopic surgical treatment without indications of malignancy based on preoperative histology or cytology.

Results: Initially, all individuals were suspected to have LEGH based on MRI findings. Postoperatively, two patients were diagnosed with LEGH, two with adenocarcinoma in situ (AIS) and minimal deviation adenocarcinoma (MDA), and two showed no notable findings on pathology (one diagnosed endometrioid carcinoma in endometrial tissue). Patients with malignancies exhibited longer surgical times and higher intraoperative blood loss. Preoperatively, no significant variation was observed in maximal lesion diameter between adenocarcinoma and LEGH. However, lesion diameter increased significantly over time in patients with GAS.

Conclusion: Laparoscopic surgery demonstrated feasibility and provided crucial diagnostic and therapeutic outcomes, with no postoperative recurrence observed in cases of malignancy, despite the challenges associated with preoperative differentiation. These findings underscore the potential of laparoscopic surgery in enhancing both diagnostic accuracy and therapeutic efficacy for cervical cystic lesions, offering promise for improved patient outcomes and management strategies in clinical practice.

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