Minilaparotomy versus laparoscopy in the treatment of benign adnexal cysts: a randomized clinical study.
OBJECTIVE
To determine advantages and disadvantages of minilaparotomy and laparoscopy in managing patients affected by benign adnexal masses.


METHODS
Prospective, randomized, clinical trial on 127 patients affected by adnexal cysts. Patients were submitted to adnexal surgery through a laparoscopic or minilaparotomy approach on a random basis.


RESULTS
Hundred and twenty-seven patients were enrolled in the study and randomly assigned to laparoscopy (63 patients) or minilaparotomy (64 patients). Characteristics of the patients and of the cysts were homogeneous between the two groups. No significant differences between the two groups were recorded in terms of operative time, intraoperative complications, ileus, length of stay and recovery time. The intraoperative rupture rate of the cyst was significantly higher in the laparoscopy group only in a subgroup of patients affected by cysts greater than 7 cm in diameter (p=0.01). Three patients randomized to laparoscopy required conversion to laparotomy. Concerning postoperative outcomes, postoperative pain and minor complications were significantly less in patients undergoing laparoscopy (p=0.001 and 0.04).


CONCLUSIONS
Operative laparoscopy appears to be the preferable approach for the management of adnexal cysts. Minilaparotomy can be considered a mini-invasive approach as well, with acceptable operative and postoperative outcomes, and is a suitable alternative in case of contraindications to laparoscopy.
Panici
Pierluigi Benedetti
PB
Department of Obstetrics and Gynecology, Università La Sapienza, Rome, Italy.
Muzii
Ludovico
L
Palaia
Innocenza
I
Manci
Natalina
N
Bellati
Filippo
F
Plotti
Francesco
F
Zullo
Marzio
M
Angioli
Roberto
R
D000291:Adnexal Diseases / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D010048:Ovarian Cysts / Q000601:surgery*; D016896:Treatment Outcome