Laparoscopic management of benign adnexal mass in obese women

Desmond Thomas, Thomas D, Marcos H. Ikeda, Ikeda M, Marcos Ikeda, Deepika K, Krishnaprasad Deepika, Carlos Medina, Medina C, Carlos A. Medina, Takacs P, Peter Takacs, Péter Takács
Journal of Minimally Invasive Gynecology · 2006 · vol. 13(4) , pp. 311–314 · doi:10.1016/j.jmig.2006.03.017 · PMID:16825072 · W2133811043
article OA: closed CC0 ⤵ 2 in-corpus citations
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This study evaluated the safety and efficacy of laparoscopic surgery for benign adnexal masses in obese women.

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Abstract

Study objectiveTo compare complications and rate of conversion to laparotomy between normal-weight, preobese, and obese women who underwent laparoscopic management of benign adnexal mass.DesignRetrospective chart review (Canadian Task Force classification II-3).SettingTertiary care teaching hospital.PatientsOne hundred seventy women who underwent laparoscopic surgery because of benign adnexal mass were placed in three groups on the basis of their body mass index (BMI) using the World Health Organization's classification (normal-weight [BMI 18.5-24.9 kg/m2], preobese [BMI 25-29.9 kg/m2], and obese [BMI > or = 30 kg/m2]).InterventionRetrospective comparison of conversions from laparoscopy to laparotomy, operative time, estimated blood loss, complications, history of pelvic inflammatory disease, endometriosis, and length of hospital stay was carried out among the different groups.Measurements and main resultsOverall, 170 laparoscopic cases were evaluated (64 with normal-weight, 67 preobese, and 39 obese women). The rate of conversion to laparotomy was significantly higher in the obese and preobese groups compared with the normal-weight women (17.9%, 17.9% vs 1.5%, p < .01). Obese women were 13 times more likely to undergo conversion than normal-weight women (OR 13.78; 95% CI 1.76-29.1). In addition, obese women had significantly longer surgeries (143 +/- 87 minutes vs 114 +/- 41 minutes [p = .04]) and longer hospital stay (1.07 +/- 1.83 days vs 0.51 +/- 1.06 days [p = .04]) when compared with normal-weight women. There was no significant difference in history of pelvic inflammatory disease, endometriosis, and adhesions at the time of laparoscopy between obese, preobese, and normal-weight women. The rate of complications was similar among the groups.ConclusionObese and preobese women undergoing laparoscopic management of benign adnexal mass were found to be at an increased risk for conversion to laparotomy, longer surgery and longer hospital stay. Obese and preobese women should be counseled extensively on morbidity associated with laparoscopy.

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MeSH descriptors

Adnexal Diseases Adnexal Diseases Laparoscopy Obesity Adnexal Diseases Adult Body Mass Index Fallopian Tubes Fallopian Tubes Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparotomy Length of Stay Obesity Ovariectomy Ovariectomy Retrospective Studies

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