Single-Port Laparoscopy Versus Conventional Laparoscopy of Benign Adnexal Masses during Pregnancy: A Retrospective Case-Control Study

Abstract

Study Objective This study aimed to compare the operative outcomes of single-port laparoscopy (SPL) with those of conventional laparoscopy (CL) of adnexal masses during pregnancy. Design Retrospective case-control study (Canadian Task Force classification II-2). Setting Tertiary care academic medical center. Patients or Participants The study included all patients who underwent laparoscopic surgery for adnexal masses during pregnancy from October 2010 to January 2020. Interventions Among them, 22 patients underwent SPL surgeries and 42 patients underwent CL surgeries.For perioperative outcome evaluation, relative data were collected. The patients were followed up by telephone for cosmetic results, pregnancy and neonatal outcomes. Measurements and Main Results No differences in maternal age, parity, multiple gestation, high-risk pregnancy, and history of cesarean section were found between the two groups. Overall cosmetic satisfaction with the scar was significantly favorable in the SPL group compared with the CL group (9.1±1.7 vs 8.1±1.3, p=0.002). While SPL surgeries took significantly longer time than CL surgeries (69.2±21.0 min vs 54.7±20.7 min, p=0.02). Operative blood loss (p=0.948), decrease in estimated hemoglobin level (p=0.779), average length of hospital stay (p=0.657), and hospitalization expenses (p=0.245) were not remarkably different between the two groups. Pregnancy outcomes, neonatal Apgar scores at 1 and 5 min, and average birth weight were also comparable. No incisional hernia was detected in both groups. Conclusion SPL provides better cosmetic satisfaction than CL, but does not cause additional perioperative danger, economic burden, adverse pregnancy, and adverse neonatal outcomes in adnexal surgery during pregnancy. Therefore, for better cosmetic outcomes, SPL could be considered as a feasible and safe surgical option for adnexal masses in pregnant women.