Short- and long-term outcomes of intraoperative spillage during laparoscopic removal of benign ovarian cysts

Background: To compare the short- and long-term outcomes in patients with and without intraoperative spillage from benign adnexal masses during laparoscopic removal. Methods: We conducted a retrospective analysis of all cases of laparoscopic removal of ovarian cysts (cystectomy or adnexectomy) in our institution between the years 2013 and 2017, excluding malignant lesions. Results: During the study period, 186 cases of ovarian cyst removal were identified. Intraoperative ovarian cyst spillage (IOCS) occurred in 104 cases (study group), while in the remaining 82 cases no spillage was reported (control group). Baseline clinical characteristics were comparable between groups. Large cyst diameter and intraperitoneal adhesions were significantly associated with the occurrence of IOCS (P = 0.008 and < 0.001, respectively). The use of an endoscopic retrieval bag was significantly inversely associated with IOCS. Postoperative complications (pain score, hospital stay, febrile illness and recurrence of ovarian cyst) were comparable between groups. Conclusions: IOCS during laparoscopic cystectomy is associated with larger cyst diameter and intraperitoneal adhesions, but not with adverse short- or long-term outcomes nor with recurrence rates.