title: Recurrence of Endometrioma Following Conservative Ovarian Endometrioma Cystectomy: Laparoscopy versus Laparotomy.
abstract: OBJECTIVE
  To investigate the recurrence rate and disease-free interval between laparoscopy versus laparotomy for the conservative surgery of endometrioma.
  
  
  METHODS
  A retrospective cohort study was conducted. The medical records of reproductive women who underwent conservative ovarian cystectomy surgery (laparoscopy or laparotomy) for endometrioma at Thammasat University Hospital were retrieved. The patients were followed through 24 months to evaluate the recurrence of endometrioma. Propensity scoring was used to adjust for confounding by indication and confounding by contraindication. Model for competing time to event was used in analysis.
  
  
  RESULTS
  One hundred and twenty-eight and 114 patients were enrolled in laparoscopy and laparotomy groups, respectively. Mean age and body weight in laparotomy group were statistically higher than those in the other group were. Mean height and body mass index were, however not statistically different in either groups. In addition, the stage of disease and bilaterality in both groups were comparable. Diameter ofendometrioma in laparotomy group was significantly larger than that in laparoscopy group (7.0 ± 2.5 vs. 6.2 ± 1.8 cm, respectively; p = 0.004). After adjusting for propensity scoring, the endometrioma recurrence rate was significantly higher in laparoscopy group as compared to laparotomy group (27.3% vs. 14.9%, respectively; p = 0.02). However, the cumulative rate of pregnancy after surgery was not statistically different (4.7% vs. 4.4%, respectively; p = 1.0).
  
  
  CONCLUSIONS
  The present study has demonstrated that the surgical technique has a strong impact on the recurrence or disease-free interval. Laparoscopy might not eradicate the disease pathology as effectively as open laparotomy in some situations, such as in cases with complexity of disease.
authors.forename: Chamnan
authors.initials: C
authors.lastname: Tanprasertkul
authors.forename: Jayanton
authors.initials: J
authors.lastname: Patumanond
authors.forename: Sakol
authors.initials: S
authors.lastname: Manusook
authors.forename: Komsun
authors.initials: K
authors.lastname: Suwannarurk
authors.forename: Charintip
authors.initials: C
authors.lastname: Somprasit
authors.forename: Opas
authors.initials: O
authors.lastname: Sreshthaputra
authors.forename: Teeraporn
authors.initials: T
authors.lastname: Vutyavanich
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data*; D010053:Ovary / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome