A Cochrane review [Abstract] 1 included 12 studies with a total of 769 subjects. Three subgroups of ovarian tumours were considered: any histological type of benign ovarian tumour, dermoid cysts and endometriomata. Laparoscopic surgery was associated with fewer adverse events of surgery (surgical injury or postoperative complications including fever or infection) (OR 0.3, 95% CI 0.2 to 0.5; 9 studies, n=482), less postoperative pain (VAS score WMD -2.4, 95% CI -2.7 to -2.0; 3 studies, n=186), greater likelihood of being pain free after two days (OR 7.4, 95% CI 4.9 to 11.3; 6 studies, n=356), and fewer days in hospital (WMD -2.9, 95% CI -3.1 to -2.7; 8 studies, n=442) than laparotomy. Laparoscopy was associated with a significant reduction in costs compared to laparotomy (WMD -USD 1045, 95% CI -1348 to -742; 1 study, n=68) in 1993. Very high levels of heterogeneity made it inappropriate to pool data on duration of surgery.
Laparoscopy was associated with reduced odds of any adverse event (surgical injury or postoperative complications) (OR 0.10, 95% CI 0.01 to 0.8; 2 studies, n=227) and lower VAS scores for pain (WMD -1.0, 95% CI -1.6 to -0.45; 1 study, n=127) compared to minilaparotomy. Duration of hospital stay ranged between 1 and 2.2 days, with substantial heterogeneity.
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