The ideal approach of ovarian dermoid cyst excision; the predicament of laparoscopy versus laparotomy

Purpose: The aim of the current retrospective study for reviewing the cases of dermoid cyst managed at our hospital during the study period, to find out the best and safest management approach after taking in consideration the related factors. Setting: This analysis took place at the department of Gynecology and Obstetrics at Jordan University Hospital. Material and methods: The retrospective records were reviewed for over 6 years (from January 2015 to January 2021). The sample of study included a total number of 87 patients operated with ovarian dermoid. Thirty-five patients (40.22%) presented with abdominal mass, 16 patients (18.39%) were accidently found to have this kind of ovarian cysts, 12 patients (13.79%) presented with pressure symptoms, 11 patients (12.64%) presented with dyspareunia and dysmenorrhea, 8 patients (09.19%) with abdominal pain, and 5 patients (05.74%) with recurrent attacks of nausea. Thirty-nine patients (44.83%) treated by laparotomy, another 39 patients (44.83%), the management procedure completed laparoscopically, and 9 patients (10.34%), the procedure started laparoscopically, then converted to laparotomy. Sixty-one patients (70.11%) were found to have right sided ovarian dermoid, while 19 patients (21.84%) were found to have bilateral, and 7 patients (08.05%) were found to have left sided one. The size of the cyst was more than 11 cm in 40 patients (45.98%), while less than 5 cm in 5 patients (5.75%). Results: ovarian cystectomy performed in 70 patients (80.46%), and salpingo-oophorectomy on 17 patients (19.54%) on both reproductive and postmenopausal group. The average blood loss and operative time were more on the laparoscopic group; 298.7 ml, 98.8 minutes respectively. Conclusion: Laparotomy and ovarian cystectomy seems to be superior to other methods of management for ovarian dermoid, particularly when the size of the cyst is more than 5 cm, and predominantly the cysts presentation bilaterally.