Comparison of therapeutic effect of ovarian endometriomas after cystectomy by laparoscopy and laparotomy

Objective: To compare the therapeutic efficacy of laparoscopy and laparotomy in the treatment of ovarian endometriomas and to make sure that laparoscopic excision of ovarian endometriomas appears to be an effective therapeutic method. Methods: The authors selected that 175 (laparoscopy group) and 157 (laparotomy group) patients who were undergone, respectively, laparoscopic and laparotomic excision of ovarian endometrioma from January 1996 to January 2003 in this hospital. Altogether 332 cases were followed-up for three months to seven years, 266 cases were successfully followed-up, the followup rate was 80.12%. By retrospective analysis on this two groups' therapeutic effects after surgery, compared this two operative methods' advantages and shortcomings. Results: Operating time (62.01±20.02 min) in laparoscopy group is under laparotomy group (94.73±21.10 min), P0.001; Fever rate (24.00%) in laparoscopy group is under laparotomy group (59.24%), P0.001; Anus exhaust 24 hours rate after surgery (73.14%) in laparoscopy group is high laparotomy group (10.83%), P0.001; The hospital stay time (3.38±1.16 d) in laparoscopy group is short laparotomy group (6.88±1.30 d), P0.001; Recovery time (9.73±3.13 d) in laparoscopy group is short laparotomy group (26.92±6.17 d), P0.001; Ameliorated dysmenorrhea in laparoscopy group: 38.38% pain free, 36.36% decreased pain, 25.25% no improvement pain, laparotomy group: 54.22% pain free, 28.92% decreased pain, 16.87% no improvement pain, P0.05; The cumulative ultrasonographic recurrence rate over 7 years were, respectively, laparoscopy group 39.16% and laparotomy group 47.49%, P0.05; The cumulative pregnancy rate with infertile women over 7 years were, respectively, laparoscopy group 51.27% and laparotomy group 58.30%, P0.05. Conclusion: Videolaparoscopy in the treatment of endometriomas is currently preferred surgical procedure and can replaces laparotomy. It is also safe and feasible for severe endometriomas.