Objective: To evaluate whether laparoscopic versus conventional surgery is of benefit in moderate-severe pelvic inflammatory disease. Methods: A cross-sectional study was designed. All consecutive patients admitted with the clinical diagnosis of Pelvic Inflammatory Disease (i.e., laboratory tests, sonography) underwent laparoscopy or laparotomy as primary surgery. Two groups were identified: Group 1, patients who underwent laparoscopy and Group 2, patients who had only laparotomy. Intraoperative and postoperative complications were compared between groups. Parametric and non parametric tests were used for statistical purposes. Results: Forty-nine patients were included in the study: in 22 was performed a laparoscopy and in 27 a laparotomy. Patients in group 1 had a shorter duration of the operation (median 30 min, range 10-120 vs median 130 min, range 40-225;p < 0.005), a shorter hospital stay (median 5.5 days, range 1-17 vs median 9 days, range 7-24) and a lower haemoglobin loss during surgery (Δ Hb : median 0.2 mg/dl, range 0.2 -4.8 vs median 1.8 mg/dl, range 0.3-2.5) than those in group 2. Considering, as control group, only patients who had a laparotomy without the performance of hysterectomy the results remained unchanged. In 4 patients in group 1 was necessary a laparotomy and none of them had postoperativie complications. With a median follow up of 33 months (2-60) no patients had relapse. Conclusions: The laparoscopic approach is technically safe and feasible in a high proportion of pelvic infections. Furthermore, laparoscopy should be the first method of management for this disease considering that it seems to have less complications than laparotomy with the same medium term results and a better compliance of patients.
Surgical treatment of moderate and severe pelvic inflammatory disease: laparoscopy versus laparotomy.
FRANCHI, Massimo Piergiuseppe;
1997-01-01
Abstract
Objective: To evaluate whether laparoscopic versus conventional surgery is of benefit in moderate-severe pelvic inflammatory disease. Methods: A cross-sectional study was designed. All consecutive patients admitted with the clinical diagnosis of Pelvic Inflammatory Disease (i.e., laboratory tests, sonography) underwent laparoscopy or laparotomy as primary surgery. Two groups were identified: Group 1, patients who underwent laparoscopy and Group 2, patients who had only laparotomy. Intraoperative and postoperative complications were compared between groups. Parametric and non parametric tests were used for statistical purposes. Results: Forty-nine patients were included in the study: in 22 was performed a laparoscopy and in 27 a laparotomy. Patients in group 1 had a shorter duration of the operation (median 30 min, range 10-120 vs median 130 min, range 40-225;p < 0.005), a shorter hospital stay (median 5.5 days, range 1-17 vs median 9 days, range 7-24) and a lower haemoglobin loss during surgery (Δ Hb : median 0.2 mg/dl, range 0.2 -4.8 vs median 1.8 mg/dl, range 0.3-2.5) than those in group 2. Considering, as control group, only patients who had a laparotomy without the performance of hysterectomy the results remained unchanged. In 4 patients in group 1 was necessary a laparotomy and none of them had postoperativie complications. With a median follow up of 33 months (2-60) no patients had relapse. Conclusions: The laparoscopic approach is technically safe and feasible in a high proportion of pelvic infections. Furthermore, laparoscopy should be the first method of management for this disease considering that it seems to have less complications than laparotomy with the same medium term results and a better compliance of patients.
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