A comparison of laparoscopy versus laparotomy for the management of adnexal masses during pregnancy over the last 16 years: retrospective study

Background: Adnexal masses during pregnancy is not rare. More and more evidences imply that operative laparoscopy for adnexal masses performed during pregnancy could be safe and feasible. We procured and evaluated the surgical, obstetric outcomes between laparoscopy and laparotomy for the management of adnexal masses during first and second trimester period in our hospital. Results 117 pregnant women with adnexal masses were treated by laparoscopy (69 cases) or laparotomy (48 cases) between July 2003 and March 2019. The laparoscopy group had a significantly lower blood loss (22.0 ± 3.4ml vs 41.7 ± 4.3ml, P = 0.0004), a shorter onset of flatus after operation (24.2 ± 0.1h vs 41.6 ± 1.9h, P < 0.0001) and a shorter hospital stay (3.5 ± 0.2 days vs 6.6 ± 0.2 days, < 0.0001) than the laparotomy group. No patient from either group required a blood transfusion. There is no significant difference in obstetric outcomes, including preterm labor and fetal loss. The median follow-up time was 3.5 years (range, 1.5–11.5 years) after surgery. The median age of the children was 2.5 years (range, 1-9.5 years). No notable abnormality was found. Conclusions In this retrospective study, compared with laparotomy, laparoscopy has successful outcome with lower blood loss, shorter onset of flatus after surgery, and shorter hospital stay, all of those suggest that operative laparoscopy could be promising for adnexal masses performed during pregnancy.