COMPARISON OF MINIMALLY INVASIVE SURGERY AND LAPAROTOMY IN THE TREATMENT OF ADNEXAL MASSES

Study Objective. To compare the outcome of laparoscopic treatment of a dnexal masses with treatment by laparotomy. The procedures, their dura tion, and associated complications also were evaluated. Design. Women were randomized to undergo either procedure based on the ward To which they were admitted. Setting. A university teaching hospital. Patients . The 192 patients were admitted with a preoperative diagnosis of adne xal mass. Interventions. Surgical procedures were cystectomy, salpinge ctomy, oophorectomy, and unilateral or bilateral salpingo-oophorectomy . Organ-preserving techniques were used wherever possible. All tissue specimens were examined histologically. Measurements and Main Results. The mean duration of surgery was statistically not significantly diff erent between the groups, 96.8 minutes for minimally invasive surgery, and 116 minutes for laparotomy. Organ preservation did reach statisti cal significance at 65.7% and 17.2%, respectively (p < 0.001). Postope rative morbidity was statistically lower in patients undergoing minima lly invasive procedures. Preoperative tumor marker levels did not corr elate well with postoperative histology. One woman in the laparotomy g roup had histologically proved ovarian cancer. Minimally invasive surg ery was converted to laparotomy in three patients in whom malignancy w as suspected at the start of operation. Conclusions. Laparoscopic mana gement of adnexal masses has definite advantages over laparotomy, for example, lower postoperative morbidity. In addition, intraoperative en doscopic diagnosis is highly accurate, and the frequency of unnecessar y procedures is lower.