title: Laparoscopy in patients over 60 years old: a prospective, randomized evaluation of laparoscopic versus open adnexectomy.
abstract: OBJECTIVE
  To compare objective and subjective parameters of surgical stress following laparoscopic and open adnexectomy in patients older than 60 years old.
  
  
  METHODS
  Twenty patients with a benign ovarian tumour were prospectively randomized to undergo adnexectomy by a laparoscopic or an open surgical procedure. Measurements included C-reactive protein; interleukin-6 before, during, and after surgery; intensity and duration of postoperative pain; and complications and recovery period. Statistical analysis consisted of analysis of variance and a Mann-Whitney U test.
  
  
  RESULTS
  The levels of the interleukin-6 and C-reactive protein differed significantly between the 2 operative procedures (P = .013) in favor of the laparoscopic approach. The laparoscopic approach was associated with a reduction in operative morbidity, postoperative pain, analgesic requirement, and recovery period.
  
  
  CONCLUSIONS
  Minimally invasive surgery is of particular benefit to elderly patients if there is a plan in place for appropriate staging and treatment by laparotomy for malignancy. It should be the first choice and may help to reduce postoperative complications.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Münster, Münster, Germany. buchweo@mednet.uni-muenster.de
authors.forename: Olaf
authors.initials: O
authors.lastname: Buchweitz
authors.forename: Stephanie
authors.initials: S
authors.lastname: Matthias
authors.forename: Michael
authors.initials: M
authors.lastname: Müller-Steinhardt
authors.forename: Eduard
authors.initials: E
authors.lastname: Malik
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D011446:Prospective Studies