TREATMENT STRATEGY AND TACTICS FOR OVARIAN TUMOR-LIKE LESIONS IN URGENT GYNECOLOGY:

Objective. To elaborate organ-saving treatment protocols for patients with urgent complications of ovarian tumor-like lesions (OTL). Subjects and methods. The study enrolled 1684 reproductive-aged patients with urgent complications of OTL. They underwent transvaginal targeted ultrasound-guided cyst puncture, sclerotherapy, laparoscopy, minilaparotomy, and traditional laparotomy. Results. The urgent complications were associated most commonly (86.2%) with ovarian retention cysts: the pathology associated with endometrioid cysts formed 13.8%. The pattern of the complications included cystic rupture, torsion, bleeding, and preperforation. Out of 1451 patients with retention cysts there were 685 (47.2%) persons who had no surgical procedure, but underwent targeted transvaginal puncture of an ovarian mass and sclerotherapy. In 151 (30.1%) of the 502 patients with ovarian retention cystic torsion, persistent pain syndrome disappeared after targeted puncture and laparoscopic detorsion was achieved in 124 (24.7%) patients. The patients with endometrioid cysts showed the highest uterine appendagectomy rate (28.6%). Conclusion. The protocols providing the wide usage of mini-invasive and conservative treatments cause a reduction in the rate of radical surgical interventions.

ovarian tumor-like lesions, urgent complications