Laparoscopic versus Laparotomic Management of Adnexal Tumor before Week 18 of Pregnancy

Hwang, Ho Myong; Lee, Chang Ho; Tae, Cheol Min; Oh, Byung Chan; Cho, Sung Nam; Jeong, Young Ju; Kim, Jong Duk; Kim, Kwan Sik

Abstract

OBJECTIVE
To evaluate the safety and benefit of laparoscopic surgery compared with laparotomy for the management of adnexal tumor during pregnancy.
METHODS
We reviewed 54 cases of adnexal tumor during pregnancy which were managed surgically at Chonbuk National University Hospital between January 1996 and July 2002. Laparoscopy was performed in 17 patients. The remaining 37 patients had laparotomy. The medical records were reviewed retrospectively to confirm variable factors, such as gestational age, operating time, surgical methods, pathologic results, and pregnancy outcomes and complications.
RESULTS
Mean gestational age at surgery was significantly different between two groups (85.2 vs 103.0 days). Operating time was not significantly different between two groups. Hospital stay (4.6 vs 7.0 days) was significantly shorter in the laparoscopy group than laparotomy group. No operative or postoperative maternal complications occured in the pregnant women who had laparoscopic surgery. Five preterm deliveries and one intrauterine fetal death occured in the laparotomy group.
CONCLUSION
Comparing with laparotomy, laparoscopic surgery allows a shorter hospital stay, a reduced rate of postoperative complications and a maternal and fetal morbidity compared. Laparoscopic surgery appears to be safe and effective during pregnancy.