Laparoscopy versus laparotomy in the management of benign unilateral adnexal masses

Study Objective. To compare operative characteristics and charges of laparoscopy and laparotomy for women with a benign unilateral adnexal mass 7 cm or less in greatest diameter. Design. Historical cohort study (Canadian Task Force classification II-2). Setting. Clinic department of obstetrics and gynecology. Patients. One hundred six women. Intervention. Unilateral oophorectomy or unilateral salpingo-oophorectomy performed by laparoscopy or laparotomy. Measurements and Main Results. When patients were compared on an intent to treat basis, no differences in greatest mass diameter (4.2 vs 4.5 cm), patient age (49.2 vs 46.4 yrs), or body mass index (26.0 vs 27.0 kg/m(2)) were found between 62 laparoscopies and 44 laparotomies. Laparoscopy was associated with longer operating times (94 vs 63 min, p<0.001), shorter hospital stay (1.6 vs 2.5 days, p<0.001), higher sterile supply charges ($1031 vs $40, p<0.001), and lower hospital room charges ($672 vs $1351, p<0.0001). No significant differences in total hospital charges, febrile morbidity, or transfusion rates were identified. Conclusion. Patient charges and early operative morbidity are similar for laparoscopy and laparotomy. Therefore, patient and surgeon preference should be a primary consideration when deciding on operative approach in carefully selected women with a unilateral adnexal mass.