A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses

被引:248
作者
Yuen, PM [1 ]
Yu, KM [1 ]
Yip, SK [1 ]
Lau, WC [1 ]
Rogers, MS [1 ]
Chang, A [1 ]
机构
[1] KWONG WAH HOSP, SHATIN, HONG KONG
关键词
ovarian masses; laparoscopy; laparotomy;
D O I
10.1016/S0002-9378(97)70447-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Our purpose was to compare the results of laparoscopy with laparotomy in the management of ovarian masses not suspected to be malignant. STUDY DESIGN: In a prospective randomized study 102 patients requiring surgical management of ovarian masses were randomly assigned to laparoscopy (52) or laparotomy (50) in a teaching hospital from July 1994 to September 1995. Inclusion criteria was tumor not suspected to be malignant with a diameter of less than or equal to 10 cm as measured by ultrasonography. All operations were performed by trainees under the supervision of an experienced surgeon. Statistical analysis included t tests and chi(2) tests. RESULTS: There were no differences in demographic characteristics between the two groups nor any difference in the size of ovarian masses, adnexal adhesion score, or frequency of bilateral disease. All the ovarian masses were benign. Endometriotic cysts and dermoid cysts were the most common disorder in the two groups. Cystectomy was performed in >70% of cases in each group. Operating time was not increased with the laparoscopic approach, and the frequency of inadvertent rupture of the ovarian masses was just as high as in laparotomy. The laparoscopic approach was associated with a significant reduction in operative morbidity (odds ratio 0.34, 95% confidence interval 0.13 to 0.88), postoperative pain and analgesic requirement, hospital stay, and recovery period. Patients in general were satisfied with the operation, but significantly more patients were satisfied with the laparoscopy scar. CONCLUSION: Operative laparoscopy should replace laparotomy in the management of benign ovarian masses.
引用
收藏
页码:109 / 114
页数:6
相关论文
共 23 条
[2]  
BATEMAN BG, 1994, FERTIL STERIL, V62, P690
[3]  
BRUMSTED JR, 1990, FERTIL STERIL, V53, P723
[4]  
COOK AS, 1991, FERTIL STERIL, V55, P663
[5]  
DIAMOND MP, 1995, GYNAECOL ENDOSC, V4, P229
[6]  
DONNEZ J, 1993, COMPLICATIONS LAPARO, P117
[7]   MACROSCOPIC CHARACTERIZATION OF OVARIAN-TUMORS AND THE RELATION TO THE HISTOLOGICAL DIAGNOSIS - CRITERIA TO BE USED FOR ULTRASOUND EVALUATION [J].
GRANBERG, S ;
WIKLAND, M ;
JANSSON, I .
GYNECOLOGIC ONCOLOGY, 1989, 35 (02) :139-144
[8]   FRONTIERS OF OPERATIVE LAPAROSCOPY - A REVIEW AND CRITIQUE OF THE EVIDENCE [J].
GRIMES, DA .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1992, 166 (04) :1062-1071
[9]  
HOWARD FM, 1995, J REPROD MED, V40, P495
[10]  
KADAR N, 1994, GYNAECOL ENDOSC, V3, P69