Laparoscopic management of tubo-ovarian abscesses

O. Buchweitz, Eduard Malik, P. Kressin, A. Meyhoefer-Malik, K. Diedrich
In: Surgical Endoscopy · 2000 · vol. 14(10) , pp. 948–950 · doi:10.1007/s004640000249 · PMID:11080409 · W2038386038
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-10 ⓘ

Laparoscopic treatment of tubo-ovarian abscesses shows that organ-preserving procedures result in fewer complications than ablative treatments, regardless of age or fertility desire.

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This retrospective chart review evaluated 60 women with tubo-ovarian abscesses treated with broad-spectrum antibiotics from 1994 to 1998, comparing laparoscopic organ-preserving treatment (incision of the abscess cavity and lavage) in 25 women with ablative treatment (laparoscopic salpingectomy or salpingo-oophorectomy) in 35 women, with telephone interviews used to assess operative and reproductive outcomes. The organ-preserving group had no operative complications or serious systemic sequelae except one postoperative readmission for lower pelvic pain, whereas the ablative group showed significantly higher rates of intraoperative and postoperative complications including intestinal perforation requiring laparotomy, multiple organ or vessel injuries, fever, bowel obstruction, and leg thrombosis. The paper reports no significant baseline differences between groups in BMI, duration of pelvic pain, admission labs, ultrasound abscess size, or extent of abscess at laparoscopy. The authors’ limitation is that this was a non-randomized retrospective study with telephone follow-up. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background The laparoscopic management of tubo-ovarian abscesses (TOA) was evaluated. The study sought to answer the following question: Does operative laparoscopy with only incision of the abscess cavity and lavage (organpreserving treatment) improve intraoperative and postoperative safety and long-term prospects of fertility as compared with laparoscopic salpingectomy or salpingo-oophorectomy (ablative treatment)?

Methods

A retrospective chart review of 60 patients with TOA undergoing laparoscopic treatment in combination with broad-spectrum antibiotics from 1994 to 1998 was performed. Patients not wishing to have children underwent salpingectomy or salpingo-oophorectomy, whereas patients wishing to remain fertile were treated by means of an organpreserving procedure. To investigate the operative and reproductive outcome, patients were interviewed by telephone.

Results

Of 60 women with TOA, 25 were treated laparoscopically, preserving the internal genital organs, and 35 underwent ablative treatment. Apart from one postoperative readmission because of lower pelvic pain in the organpreserving group, there were no operative complications or serious systemic sequelae. In contrast, there was a significantly higher incidence of intraoperative and postoperative complications when ablative treatment was performed: one intestinal perforation requiring subsequent laparotomy, four serosal lesions, two lesions of the greater omentum, two lacerated collaterals of the internal iliac artery, one postoperative fever higher than 38°C for 2 days, two bowel obstructions, one thrombosis of the upper leg, and one thrombosis of the lower leg. There were no significant differences between the two patient groups in body mass index, duration of pelvic pain, laboratory findings at admission, ultrasonic assessment of abscess size, and the extent of the abscess at laparoscopy.

Conclusions

When laparoscopic treatment of TOA is performed, organ-preserving treatment should be chosen irrespective of the patient’s age or desire to have children because of the risk of complications. Similar content being viewed by others

References

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