Efficacy and safety of an Aron Alpha method in managing giant ovarian tumors

Abstract

Background: Giant malignant tumors have an increased risk of intraoperative rupture, which might lead to a worse disease condition and tumor recurrence. We performed a clinical study on patients with a giant ovarian mass who underwent laparoscopy combined with an Aron Alpha method.

Methods: This retrospective clinical study spanned from January 2016 to September 2022 and included 23 patients with giant ovarian tumors treated with an Aron Alpha method.

Results: The mean age of the subjects was 47.6 ± 17.8 years, mean tumor diameter 20.4 ± 5.8 cm, mean surgical duration 87.2 ± 33.1 min, and mean hemorrhage volume 94.1 ± 92.2 mL. No patient experienced intraoperative tumor rupture or surgery-related symptoms. Histopathology of excised samples revealed serous cyst adenoma and mucinous cystadenoma, mucinous cystadenoma of borderline malignancy and mature cystic teratoma, and endometriotic cyst adenoma in 6, 4, and 3 patients, respectively. The mean hospitalization period was 6.0 ± 1.2 days, and the hospitalization period was not extended in any subject.

Conclusion: The Aron Alpha method allows tumor resection without capsular rupture and is a useful, minimally invasive surgical method for resecting giant ovarian tumors in which malignancy cannot be ruled out.

Keywords: Aron Alpha method; Giant ovarian tumor; Laparoscopy; Malignant ovarian tumor; Mini-laparotomy; Minimally invasive surgery.

Fig. 1

Surgical findings. A: The intraperitoneal cavity was observed laparoscopically, and ascitic fluid was collected for cytology tests (⇒). B: After intraperitoneal observation, a 3–6 cm incision was made in the center of the lower abdomen and a Gosset retractor was attached. C: To prevent Aron Alpha from dripping into the surrounding tissues, the area surrounding the tumor was padded with gauze (⇒⇒). D: Aron Alpha was applied to the tumor surface in a lattice pattern, and a sterilized plastic bag was fitted tightly over the ovarian tumor and stuck to it (⇒⇒⇒). E: After confirming the adhesion of the ovarian tissue and bag, the plastic bag was pierced with a sharp blade, and the intratumoral fluid was aspirated using a tube (⇒⇒⇒⇒). F: After intratumoral fluid aspiration, the tumor was guided out of the patient’s body and more intratumoral fluid was aspirated. The tumor was then lifted out of the body. After checking the route of the ureter, the pelvic funnel ligament was ligated and severed, and the appendages were excised.