Complications and long-term outcomes after adnexal surgery by laparotomy and laparoscopy

Study Objective. To assess complications and subjective outcomes after adne xal surgery by laparotomy and laparoscopy. Design. Observational study (Canadian Task Force classification 11-2). Setting. University-affiliated hospital. Patients. Two-hundred twenty-eight women requiring adnexal surgery for beni gn indications. Interventions, The 114 patients who underwent laparotomy and 114 having lap aroscopy were followed prospectively for 1 year. Two questionnaire-based ev aluations were undertaken to determine subjective outcomes. To evaluate pos sible later surgical procedures, hospital records were reviewed 4 years aft er operation. Measurements and Main Results. No major complications occurred in the lapar otomy group. The two (1.8%) in the laparoscopy group were intestinal injury and aortal injury both in women who had previously undergone laparotomy. R ates of minor complications were 11.4% for laparotomy and 7.0% for laparosc opy. Two patients in both groups were readmitted. No difference was found b etween groups in need for additional adnexal procedures up to 4 years after operation. After 1 year, frequencies of subjective complaints and satisfac tion with surgical procedure did not differ significantly Mean hospital cos t per patient was less for laparoscopy than for laparotomy. Conclusion. No statistically significant differences were seen after adnexa l surgery by laparoscopy and laparotomy with regard to frequency of complic ations and subjective outcomes. Laparoscopy in women who have previously un dergone laparotomy may be associated with a slightly greater risk of major complications than another laparotomy.