A retrospective study of spillage of dermoid cysts during laparoscopic cystectomy

Laparoscopic cystectomy is widely performed for dermoid cysts. However, the total laparoscopic approach is associated with greater risk of intraoperative spillage (IOS). Although a few cases of chemical peritonitis (CP) have been reported following IOS, the association remains unclear. We conducted a retrospective study of spillage of dermoid cysts during laparoscopic cystectomy in a single institution. A total of 141 patients who underwent laparoscopic cystectomy for dermoid cysts at our institution between 2012 and 2016 were identified. Eighty patients (57%) developed IOS, and had a significantly longer operative time (60.0±25.7 min vs. 47.9±11.9 min, p<0.01) compared with patients who did not develop IOS. We did not observe significant differences in cyst diameter (6.8±2.4 cm vs. 6.1±1.4 cm, p=0.06), or in the rate of postoperative fever between the groups. No patients developed CP. We concluded that controlled IOS was not associated with postoperative complications, although further investigation is needed.