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Hum. Reprod. Advance Access originally published online on July 8, 2004
Human Reproduction 2004 19(10):2367-2371; doi:10.1093/humrep/deh413
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Human Reproduction vol. 19 no. 10 © European Society of Human Reproduction and Embryology 2004; all rights reserved

A prospective randomized study of laparoscopy and minilaparotomy in the management of benign adnexal masses

Francesco Fanfani1, Anna Fagotti1, Alfredo Ercoli2, Giuseppe Bifulco1, Romina Longo2, Salvatore Mancuso2 and Giovanni Scambia1,3

1 Department of Oncology, Catholic University of the Sacred Heart, Campobasso and 2 Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy

3 To whom correspondence should be addressed at: Department of Gynaecology, Catholic University, L.go A. Gemelli, 8, 00168, Rome, Italy. Email: giovanni.scambia{at}rm.unicatt.it

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.

Key words: adnexal masses/laparoscopy/minilaparotomy


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