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Laparoscopy versus laparotomy for benign ovarian tumor: a systematic review and meta-analysis

Authors

  • L.R. MEDEIROS,

    Corresponding author
    1. *Postgraduate Program in Epidemiology and †Postgraduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; ‡Public Health Postgraduate Course at Universidade Luterana do Brasil, Porto Alegre, Brazil; §Postgraduate Program in Medical Science, Porto Alegre Federal Faculty of Medical Science, Porto Alegre, Brazil; ‖Department of Obstetrics and Gynecology, School of Women’s & Infants’ Health, University of Western Australia, Perth, Western Australia; and ¶Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
      Lidia Rosi Medeiros, MD, MSc, José de Alencar 1244 apt 1009, Porto Alegre, RS, CEP 90880-480, Brasil. Email: lidia.rosi@terra.com.br; lidiarosi@hotmail.com
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  • A.T. STEIN,

    1. *Postgraduate Program in Epidemiology and †Postgraduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; ‡Public Health Postgraduate Course at Universidade Luterana do Brasil, Porto Alegre, Brazil; §Postgraduate Program in Medical Science, Porto Alegre Federal Faculty of Medical Science, Porto Alegre, Brazil; ‖Department of Obstetrics and Gynecology, School of Women’s & Infants’ Health, University of Western Australia, Perth, Western Australia; and ¶Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
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  • J. FACHEL,

    1. *Postgraduate Program in Epidemiology and †Postgraduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; ‡Public Health Postgraduate Course at Universidade Luterana do Brasil, Porto Alegre, Brazil; §Postgraduate Program in Medical Science, Porto Alegre Federal Faculty of Medical Science, Porto Alegre, Brazil; ‖Department of Obstetrics and Gynecology, School of Women’s & Infants’ Health, University of Western Australia, Perth, Western Australia; and ¶Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
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  • R. GARRY,

    1. *Postgraduate Program in Epidemiology and †Postgraduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; ‡Public Health Postgraduate Course at Universidade Luterana do Brasil, Porto Alegre, Brazil; §Postgraduate Program in Medical Science, Porto Alegre Federal Faculty of Medical Science, Porto Alegre, Brazil; ‖Department of Obstetrics and Gynecology, School of Women’s & Infants’ Health, University of Western Australia, Perth, Western Australia; and ¶Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
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  • S. FURNESS

    1. *Postgraduate Program in Epidemiology and †Postgraduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; ‡Public Health Postgraduate Course at Universidade Luterana do Brasil, Porto Alegre, Brazil; §Postgraduate Program in Medical Science, Porto Alegre Federal Faculty of Medical Science, Porto Alegre, Brazil; ‖Department of Obstetrics and Gynecology, School of Women’s & Infants’ Health, University of Western Australia, Perth, Western Australia; and ¶Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
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  • This review is an edited version of that published in the Cochrane Library 2005 (Cochrane Database Syst Rev 2005;20:CD004751). Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms. The Cochrane Library should be consulted for the most recent version of the review.

Lidia Rosi Medeiros, MD, MSc, José de Alencar 1244 apt 1009, Porto Alegre, RS, CEP 90880-480, Brasil. Email: lidia.rosi@terra.com.br; lidiarosi@hotmail.com

Abstract

To determine the efficacy, safety, and cost of laparoscopic surgery compared with laparotomy in women with ovarian tumors assumed to be benign. This study is a systematic review. We searched (MEDLINE, EMBASE, LILACS, and COCHRANE LIBRARY) trials registers and reference lists of published trial reports. Six randomized controlled trials were identified involving 324 patients. Duration of surgery, adverse effects of surgery, pain, length of hospital stay, and economic outcomes were compared. The mean duration of surgery was longer in the laparoscopy group overall (weighted mean difference 11.39, 95% CI 0.57–22.22). The pooled estimate for febrile morbidity decreased for laparoscopy (Peto OR 0.34, 95% CI 0.13–0.88). The odds of any adverse effect were decreased after laparoscopic procedures (Peto OR 0.26, 95% CI 0.12–0.55). The odds of being pain free were significantly greater for the laparoscopy group (Peto OR 7.35, 95% CI 4.3–12.56). Mean length of hospital stay was shorter in the laparoscopy group with reduction of 2.79 days (95% CI −2.95 to −2.62). In economic outcomes, there was a significant reduction of US$1045 (95% CI −1361 to −726.97) in the laparoscopy group. Laparoscopy is associated with a reduction in the following: febrile morbidity, urinary tract infection, postoperative complications, postoperative pain, days in hospital, and total cost. These findings should be interpreted with caution as only a small number of studies were identified including a total of only 324 women.

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