A RANDOMIZED PROSPECTIVE-STUDY OF LAPAROSCOPY AND LAPAROTOMY IN THE MANAGEMENT OF BENIGN OVARIAN MASSES

OBJECTIVE: Our purpose was to compare the results of laparoscopy with laparotomy in the management of ovarian masses not suspected to be mal ignant. STUDY DESIGN: In a prospective randomized study 102 patients r equiring surgical management of ovarian masses were randomly assigned to laparoscopy (52) or laparotomy (50) in a teaching hospital from Jul y 1994 to September 1995. Inclusion criteria was tumor not suspected t o be malignant with a diameter of less than or equal to 10 cm as measu red by ultrasonography. All operations were performed by trainees unde r the supervision of an experienced surgeon. Statistical analysis incl uded t tests and chi(2) tests. RESULTS: There were no differences in d emographic characteristics between the two groups nor any difference i n the size of ovarian masses, adnexal adhesion score, or frequency of bilateral disease. All the ovarian masses were benign. Endometriotic c ysts and dermoid cysts were the most common disorder in the two groups . Cystectomy was performed in >70% of cases in each group. Operating t ime was not increased with the laparoscopic approach, and the frequenc y of inadvertent rupture of the ovarian masses was just as high as in laparotomy. The laparoscopic approach was associated with a significan t reduction in operative morbidity (odds ratio 0.34, 95% confidence in terval 0.13 to 0.88), postoperative pain and analgesic requirement, ho spital stay, and recovery period. Patients in general were satisfied w ith the operation, but significantly more patients were satisfied with the laparoscopy scar. CONCLUSION: Operative laparoscopy should replac e laparotomy in the management of benign ovarian masses.