A prospective randomized study of laparoscopy and minilaparotomy in the management of benign adnexal masses.
BACKGROUND
Recent prospective and randomized studies have demonstrated that laparoscopy is better than laparotomy in the treatment of benign adnexal masses. The aim of this study is to analyse the perioperative outcomes of laparoscopy and minilaparotomy in these patients, in a prospective and randomized manner.


METHODS
Between January 2003 and August 2003, 100 consecutive women with a diagnosis of presumed benign adnexal mass and requiring surgical treatment were randomly assigned to minilaparotomy and laparoscopy. Randomization was centralized and computer-based.


RESULTS
All operative procedures were performed without conversion to laparotomy. In the group of patients submitted to minilaparotomy, a shorter operating time than patients submitted to operative laparoscopy (mean+/-SD: 71.9+/-31.8 versus 87.0+/-44.8 min; P<0.05) was found. On the other hand, there were significant differences in terms of postoperative ileus (1.1+/-0.4 days in laparoscopy and 1.4+/-0.6 in minilaparotomy P<0.023), without affecting the day of discharge. No intraoperative or early complications were registered in either group.


CONCLUSIONS
Taking into account that laparoscopy has to be considered the first choice for benign adnexal surgery, our data suggest that minilaparotomy could offer the gynaecology surgeon a valid alternative in the minimally invasive surgery field, especially in specific settings.
Fanfani
Francesco
F
Department of Oncology, Catholic University of the Sacred Heart, Campobasso, Rome, Italy.
Fagotti
Anna
A
Ercoli
Alfredo
A
Bifulco
Giuseppe
G
Longo
Romina
R
Mancuso
Salvatore
S
Scambia
Giovanni
G
D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors