Laparotomy versus laparoscopy for the treatment of adnexal masses during pregnancy.

Background: Laparoscopy has been highlighted as an effective surgical modality for diverse pelvic organ diseases. However, its surgical and obstetric efficacy has not been fully confirmed in pregnant women because of the absence of a large comparative study. The objective of this study was to compare outcomes between laparotomy and laparoscopic surgery for adnexal masses during pregnancy.

Methods: A retrospective analysis of 262 pregnant women who underwent laparotomy or laparoscopic surgery for adnexal masses between 2000 and 2009 was performed.

Results: Of the 262 women, 174 (66.4%) underwent laparotomy and 88 (33.6%) underwent laparoscopic surgery for adnexal masses. The laparoscopy group had a significantly shorter mean operative time (60.7 ± 27.1 vs 69.7 ± 24.4 min, P = 0.002) and mean hospital stay (4.7 ± 1.7 vs 6.6 ± 1.3 days, P < 0.001) than the laparotomy group. In multivariate analysis, there was no significant difference between laparoscopy and laparotomy group in obstetric outcomes, including preterm delivery and miscarriage rate, after adjusting for confounding factors, such as gestational age at surgery, emergency surgery and mass size.

Conclusions: The laparoscopic approach appears to offer a suitable alternative to laparotomy, which, in our setting, was associated with shorter operative times and hospital stays than laparotomy.