Laparoendoscopic Single-site Compared With Conventional Laparoscopic Ovarian Cystectomy for Ovarian Endometrioma.

Abstract

To estimate the efficacy of laparoendoscopic single-site (LESS) ovarian cystectomy in ovarian endometrioma. Retrospective study. Canadian Task Force Classification II-2. University hospital. Three hundred forty-three premenopausal women with previously untreated ovarian endometrioma. The surgical and follow-up outcomes were compared between LESS (n = 154) and conventional laparoscopic ovarian cystectomy (n = 189). Four patients (2.6%) in the LESS group but no patients in conventional group required additional ports (p = .040). No patient in either group required conversion to laparotomy. Operating times, estimated blood loss, perioperative hemoglobin level changes, and transfusions did not differ between groups. However, the length of postoperative hospital stay was significantly shorter in the LESS group (2 ± .4 days vs 2.3 ± .8 days, p = .001) and significantly more patients in this group were discharged within 2 days of surgery (93.5% vs 79.4%, p < .001). Perioperative complications occurred in 1 patient (0.6%) in the LESS group and in 2 patients (1.1%) in the conventional group (p > .999). The LESS group showed significantly lower pain scores at 16 (3.2 vs 3.6, p < .001), 24 (2.8 vs 3, p = .004), and 30 hours (2.7 vs 3, p = .040) after surgery. The requirement for additional analgesics was significantly lower in the LESS group (27.9% vs 45%, p = .001). After a median follow-up time of 48 months, 11 patients (7.1%) in the LESS group and 21 patients (11.1%) in the conventional group showed recurrent endometrioma (p = .209). LESS ovarian cystectomy has similar feasibility and efficacy with conventional laparoscopic surgery in the management of endometrioma. However, LESS is associated with less postoperative pain, lower analgesic requirement, and earlier discharge.