Laparotomy versus laparoscopy for the treatment of adnexal masses during pregnancy
Laparotomy versus laparoscopy for the treatment of adnexal masses during pregnancy
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DOI：
10.1111/j.1479-828x.2011.01380.x
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发表时间：
2012-02-01
影响因子：
1.7
通讯作者：
Kim, Tae-Jin
中科院分区：
文献类型：
--
作者：
Koo, Yu-Jin;Kim, Hyun Ja;Kim, Tae-Jin
背景：腹腔镜检查已被认为是治疗多种盆腔器官疾病的有效手术方式。然而，由于缺乏大规模的比较研究，其手术和产科疗效尚未在孕妇中得到充分证实。本研究的目的是比较妊娠期间剖腹探查术和腹腔镜手术治疗附件肿块的结果。方法：对 2000 年至 2009 年间接受开腹手术或腹腔镜附件肿块手术的 262 名孕妇进行回顾性分析。结果：在 262 名妇女中，174 名（66.4%）接受了剖腹手术，88 名（33.6%）接受了腹腔镜手术。腹腔镜手术治疗附件肿块。腹腔镜组的平均手术时间（60.7 +/- 27.1 vs 69.7 +/- 24.4 分钟，P = 0.002）和平均住院时间（4.7 +/- 1.7 vs 6.6 +/- 1.3 天，P < 0.001）明显短于剖腹手术组。在多变量分析中，在调整了手术孕龄、急诊手术和肿块大小等混杂因素后，腹腔镜组和开腹手术组在产科结局（包括早产率和流产率）方面没有显着差异。结论：腹腔镜手术似乎提供了开腹手术的合适替代方案，在我们的背景下，腹腔镜手术比开腹手术的手术时间和住院时间更短。
Background: Laparoscopy has been highlighted as an effective surgical modality for diverse pelvic organ diseases. However, its surgical and obstetric efficacy has not been fully confirmed in pregnant women because of the absence of a large comparative study. The objective of this study was to compare outcomes between laparotomy and laparoscopic surgery for adnexal masses during pregnancy.Methods: A retrospective analysis of 262 pregnant women who underwent laparotomy or laparoscopic surgery for adnexal masses between 2000 and 2009 was performed.Results: Of the 262 women, 174 (66.4%) underwent laparotomy and 88 (33.6%) underwent laparoscopic surgery for adnexal masses. The laparoscopy group had a significantly shorter mean operative time (60.7 +/- 27.1 vs 69.7 +/- 24.4 min, P = 0.002) and mean hospital stay (4.7 +/- 1.7 vs 6.6 +/- 1.3 days, P < 0.001) than the laparotomy group. In multivariate analysis, there was no significant difference between laparoscopy and laparotomy group in obstetric outcomes, including preterm delivery and miscarriage rate, after adjusting for confounding factors, such as gestational age at surgery, emergency surgery and mass size.Conclusions: The laparoscopic approach appears to offer a suitable alternative to laparotomy, which, in our setting, was associated with shorter operative times and hospital stays than laparotomy.