Outpatient surgery in gynecologic oncology.

During the review period, the literature on outpatient gynecologic oncology surgery has focused on two major management problems. The first questions the treatment of cervical dysplasia with local destruction and proposes that excisional biopsy using either the carbon dioxide laser or low voltage loop diathermy is a safe procedure in the outpatient setting with low morbidity and the advantage of histology to exclude microinvasion disease. However, long-term efficacy and complication rates need to be evaluated. The second raises the possibility of extending the role of the laparoscopist to include the management of all pelvic masses using new techniques. These articles represent the beginning of the discussion on the limits that exist (or should exist) in such surgery as many become highly facile endoscopists. Further studies will be needed to determine the necessary parameters to eliminate from this approach women who are at high risk of having a pelvic malignancy.