الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Endometriomas are pseudocysts formed by invagination of the ovarian cortex, which is sealed off by adhesions. Endometriomas vary from small blue-black subcentimeter implants to large multiloculated hemorrhagic cysts, which may replace normal ovarian tissue completely, giving an appearance that has been called “chocolate cyst”. There is a general consensus amongst gynecologists that ovarian endometriomas require surgical treatment due to the ineffectiveness of medical therapies. One of the most widespread surgical techniques to excise endometriotic cysts is laparoscopic stripping. The surgical treatment of endometriomas, on one hand it represents a way to immediately remove the disease, reduce relapse incidence, improve symptoms like dyspareunia and improve sexual life, on the other hand, it affects the ovarian reserve. The aim of the present study was to determine which is the best method for management of unilateral ovarian endometrioma with short duration of operation, hospital stay, less blood loss and that maintain more ovarian reserve. In the present study, a sample size is 60 cases with unilateral ovarian endometrioma to be randomized into 2 groups, laparoscopy group (n=30) or open laparotomy group (n=30). Laparoscopy group underwent ovarian cystectomy by use of stripping technique, while laparotomy group underwent cystectomy through Pfannenstiel incision. There were no significant difference between laparoscopy group and laparotomy group as regard age, weight, parity and preoperative assessment of ovarian reserve (AFC - ovarian volume). There were significant difference between laparoscopy group and laprotomy group as laparoscopic surgical excision was better than laparotomic excision with shorter duration of operation, shorter hospital stay and less blood loss. Postoperative assessment of ovarian reserve as regard AFC and ovarian volume showed that laparoscopy group presented by marked decrease than laparotomy group. This means that laparoscopy is better than laparotomy at short term complications (duration of operation, hospital stay and blood loss) but worse at long term complications (AFC – ovarian volume).
This study suggests that laparoscopy is better than laparotomy at short term complications (duration of operation, hospital stay and blood loss) but worse at long term complications (AFC – ovarian volume). However, further studies in a larger number of patients are required to make certain judgments befor drawing a final conclusion.