Resection of mesothelial cyst of uterine round ligament by laparoscopic transabdominal preperitoneal procedure alone or combined with open surgery

Our plain-English summary of Resection of mesothelial cyst of uterine round ligament by laparoscopic transabdominal preperitoneal procedure alone or combined with open surgery, by D. Chen, P. Zhang, H. Zhang, et al (The Journal of International Medical Research, 2019).

The study

• Authors: D. Chen, P. Zhang, H. Zhang, M. Guo, W. Wang, Z. Zhang
• Journal: The Journal of International Medical Research
• Published: 2019;47(11):5475-5482
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: Surgical treatment of a mesothelial cyst of the uterine round ligament (MCURL), an uncommon entity, has been rarely documented. In this article, we present our experience with excision of MCURLs.

Methods: The records of all female patients undergoing surgical removal of a groin mass in our department from March 2013 to November 2018 were retrospectively reviewed. Demographic information, clinical data, and follow-up outcomes were collected and analyzed.

Results: Among 298 women who underwent groin hernia repair, 17 (5.7%) had MCURLs. Of these 17 patients, 13 were aged 30 to 45 years and 15 had a normal body mass index (18.5–23.9 kg/m2). MCURLs occurred predominantly on the right side (11/17). Approximately half of the patients (9/17) were preoperatively misdiagnosed with inguinal hernias. Approximately 70% (12/17) of the lesions were localized medially to the inner ring of the inguinal canal and excised by a laparoscopic transabdominal preperitoneal (TAPP) procedure alone. Five patients required open surgery following the TAPP procedure because the cyst extended distally beyond the inner ring. No recurrence was noted during the entire follow-up period.

Conclusion: Most MCURLs were localized medially to the inner ring of the inguinal canal and could be excised by a TAPP procedure.

In plain English

This study reviewed the records of women who had surgery for a groin lump at Linyi People's Hospital in Shandong, China, from March 2013 to November 2018. It looked for a rare cyst of the round ligament of the uterus, called a mesothelial cyst. The article does not discuss asbestos or mesothelioma. Of 298 women who had groin hernia repair, 17 (5.7%) had this cyst. They were aged 19 to 46, and 11 of the 17 had it on the right side. Before surgery, 9 had been diagnosed with an inguinal hernia. All 17 first had a laparoscopic (keyhole) operation called TAPP. This alone removed the cyst in 12 women. In the other 5, the cyst reached beyond the inner ring of the groin canal, and open surgery was added. All recovered uneventfully, and no recurrence was seen during 0.5 to 5.0 years of follow-up. The authors concluded that most of these cysts can be removed by TAPP. They noted that the study included only 17 patients from one center.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: retrospective review of hospital records (surgical case series)
• Who was studied: 17 women whose mesothelial cyst of the uterine round ligament was confirmed by histopathology, out of 298 women who underwent groin hernia repair, Department of General Surgery, Linyi People's Hospital, Shandong, China, March 2013 to November 2018; aged 19 to 46 years
• Main results:
  • 17 of 298 women (5.7%) who underwent groin hernia repair were diagnosed with a mesothelial cyst of the uterine round ligament
  • The 17 patients were aged 19 to 46 years
  • The mean body mass index of the 17 patients was 21.6
  • 11 of the 17 women had the mass on the right side
  • Before surgery, 8 of the 17 patients were diagnosed with the cyst and 9 with an inguinal hernia
  • Coexisting inguinal hernias were found in 7 of the 17 patients during surgery
  • The TAPP procedure alone completely removed the cyst in 12 patients
  • In the other 5 patients the cyst extended beyond the inner ring of the inguinal canal, and open surgery was added after the TAPP procedure
  • All 17 patients recovered uneventfully, with no recurrence during follow-up of 0.5 to 5.0 years
• The authors' conclusion: The authors concluded that most of these cysts lie medial to the inner ring of the inguinal canal and can be removed by the TAPP procedure. They also concluded that the TAPP procedure might be a more favorable choice than open surgery for these cysts.
• Limitations the authors state:
  • Only 17 patients from a single center were included. The authors say this may have led to overestimation of the results and limits how far the findings can be generalized.

Topics

Medical terms in this study, explained in our Lexicon: Inguinal Hernia, Inguinal Canal.

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