A Comparative Study of Laparoscopy and Laparotomy for Ovarian Cystectomy and Salpingo-oophorectomy-การเปรียบเทียบผลการรักษาผู้ป่วยเนื้องอกรังไข่ชนิดถุงน้ำเดียวโดยการผ่าตัดผ่านกล้องกับผ่าตัดเปิดหน้าท้อง

บทคัดย่อ

                 The objective of this cross-sectional non-randomized analytical study was to compare the efficacy of laparoscopy and laparotomy for ovarian cystectomy and salpingo-oophorectomy. It included 115 patients requiring surgical management of simple ovarian cysts, assigned to laparoscopy
(35 cases) or laparotomy (80 cases). The data was collected from the medical records and special designed forms of Somdejprasangkharaj 17th hospital from October 2001 to September 2007. There were no differences in demographic and clinical characteristics variable between the two groups. Serous cystadenoma and functional cyst were the most common disorder in the laparoscopy groups. Salpingo-oophorectomy was carried out in 54.28 percent, of the laparoscopy cases were done in and 53.75 percent of laparotomy groups. The operation time (114 ± 33.2 min vs 72.2 ± 20.3 min), the treatment cost (22,355 ± 2181 baht vs 18,498 ± 1955 baht), hospital stays (2.0 ± 1.1 days vs 5.4 ± 3.2 days), the maximum VNS (6.3 ± 1.2 vs 8.2 ± 0.8) and the recovery periods (20.5 ± 1.1 days vs 40.8 ± 11.3 days) were significantly difference. There were no differences in blood loss and hematocrit before and after operation (no anemia) between the two groups. There was no increase the
major risk of complication rate (RR < 1). The complications were blood loss, bowel injury, post-op fever, UTI and wound infection. No case of had to change over from laparoscopy to laparotomy. The size of ovarian cysts, in laparoscopy group, had no effect on the operation time and blood loss. Ovarian cystectomy or salpingo-oophorectomy by laparoscopy is less painful, less days of admission
and can result in quick recovery relative to laparotomy. Morever, the operation by laparoscopy does not increase intra-op, post-op complications and blood loss. The size of ovarian cyst does not effect the operation time and blood loss in laparoscopy group. Ovarian cystectomy or salpingooophorectomy by laparoscopy, in patients less than 40 years old, is the alternative and effective
choice in the management of simple ovarian cyst by well trained gynecologist.

Key words: ovarian cystectomy, salpingo-oophorectomy, laparoscopic surgery, efficacy