Surgical Outcomes of Laparoscopy Versus Laparotomy for Treatment of Small Benign Ovarian Masses; Prospective Study

Background: Adnexal masses are common neoplastic lesions in females. 
Laparoscopy is considered the gold standard for treatment of benign ovarian 
cysts. Compared with traditional surgery by laparotomy, operative laparoscopy 
is associated with a shorter hospital stay, faster recovery, decreased costs, and a 
lower incidence of postoperative adhesion formation. In this study we aimed for 
comparison between laparoscopy and conventional open exploration for benign 
ovarian masses.
Methods: This prospective study for females aged 18 – 67 years with ovarian 
mass referred to surgical oncology department in SECI, Assiut University 
during 2018-2019 by convenience sampling. This study includes 15 cases for 
laparoscopic group and 15 cases for laparotomy group. Statistical Package for 
the Social Sciences (SPSS 24) was used for analysis.
Results: Thirty patients presented with benign ovarian lesions (15 patients 
underwent laparoscopic excision and the other 15 patients underwent 
conventional open excision). The mean age for laparoscopic cases was about 
41.93 ± 14.5 years old and about 39.80 ± 12.4 years old for open cases. The 
mean duration of surgery and anesthesia in laparoscopic group was significantly 
more than in laparotomy patients with p-value < 0.001 but the estimated blood 
loss (EBL) was higher for open cases (about 1.63 ± 0.1L) while for laparoscopic 
cases was 0.10 ± 0.01L with p-value < 0.001. There were no significant 
differences between the two patient groups as regards intraoperative 
complications with p-value = 0.524. For laparoscopic cases, extraction of the 
ovarian lesions either by Pfannenstiel incision in 9 cases (60%) while 3 cases 
(20%) from trocar sites and the other 3 cases (20%) extraction of the specimen 
done transvaginally. For open exploration cases, 11 cases (73.3%) explored by 
midline incision and 4 cases (26.7%) done through Pfannenstiel incision. postoperative bowel recovery, postoperative pain, hospital stay were significantly 
better for laparoscopic group with p-value < 0.001.
Conclusion: Laparoscopic management of ovarian masses is a better choice for 
the management of benign ovarian mass with better thorough exploration and 
faster bowel recovery, less blood loss, shorter time of hospitalization and less 
post-operative pain but longer operative time.