Effect of surgical experience in total laparoscopic cystectomy for mature ovarian cystic teratomas on patient outcomes

Objective: To compare one surgeon's outcomes involving total laparoscopic cystectomies (TLCs) for mature ovarian cystic teratomas between two time periods (1995-1998 and 2007-2008). Design: Retrospective study (Canadian Task Force Classification III). Setting: Two university hospitals.Patients: Sixty-three women with mature cystic teratomas.Interventions: Women who underwent TLCs in 1995-1998 or 2007-2008 for mature cystic teratomas.Main outcome, Measures: We determined the age of the patient, diameter of the tumor, surgical time, blood loss, intra-operative leakage, and post-operative hospital stay, Results: In 32 women, 38 mature cystic teratomas were treated by TLC during 1995-1998 (group A). In 31 women, 32 mature cystic teratomas were treated by TLC during 2007-2008 (group B). The 70 mature cystic teratomas were performed by one surgeon (the first author). The incidence of intra-operative leakage was significantly decreased in group B compared to group A (2 vs. 16, P<0.001) and the post-operative hospital stay was significantly shorter in group B compared to group A (mean, 4.0 vs. 6.6 days, P<0.001). The age of the patients, diameter of the tumor, surgical time, and blood loss were not significantly different between groups A and B. Conclusion: Increased laparoscopic surgical experience was significantly associated with a decreased incidence of intra-operative leakage during TLC, and may reflect advances in laparoscopic instrumentation.