title: Complications and long-term outcomes after adnexal surgery by laparotomy and laparoscopy.
abstract: OBJECTIVE
  To assess complications and subjective outcomes after adnexal surgery by laparotomy and laparoscopy.
  
  
  METHODS
  Observational study (Canadian Task Force classification II-2).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Two-hundred twenty-eight women requiring adnexal surgery for benign indications.
  
  
  METHODS
  The 114 patients who underwent laparotomy and 114 having laparoscopy were followed prospectively for 1 year. Two questionnaire-based evaluations were undertaken to determine subjective outcomes. To evaluate possible later surgical procedures, hospital records were reviewed 4 years after operation.
  
  
  RESULTS
  No major complications occurred in the laparotomy group. The two (1.8%) in the laparoscopy group were intestinal injury and aortal injury, both in women who had previously undergone laparotomy. Rates of minor complications were 11.4% for laparotomy and 7.0% for laparoscopy. Two patients in both groups were readmitted. No difference was found between groups in need for additional adnexal procedures up to 4 years after operation. After 1 year, frequencies of subjective complaints and satisfaction with surgical procedure did not differ significantly. Mean hospital cost per patient was less for laparoscopy than for laparotomy.
  
  
  CONCLUSIONS
  No statistically significant differences were seen after adnexal surgery by laparoscopy and laparotomy with regard to frequency of complications and subjective outcomes. Laparoscopy in women who have previously undergone laparotomy may be associated with a slightly greater risk of major complications than another laparotomy.
authors.affiliation: Departments of Obstetrics and Gynecology, University of Turku, Finland.
authors.forename: S S
authors.initials: SS
authors.lastname: Meltomaa
authors.forename: M O
authors.initials: MO
authors.lastname: Taalikka
authors.forename: H Y
authors.initials: HY
authors.lastname: Helenius
authors.forename: J I
authors.initials: JI
authors.lastname: Mäkinen
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000191:economics; D007813:Laparotomy / Q000009:adverse effects* / Q000191:economics; D011446:Prospective Studies