Advantages of open laparoscopic surgery over exploratory laparotomy in patients with tubo-ovarian abscess.

Study Objective: To compare laparoscopic surgery and conventional laparotomy in managing patients with tubo-ovarian abscess (TOA).

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Regional hospital.

Patients: Sixty-nine women with clinically suspicious TOA.

Intervention: Operative laparoscopy or laparotomy.

Measurements And Main Results: Laparoscopic surgery in 19 women had significant advantages over laparotomy in 37 women. It decreased hospital stay (5.37 +/-1.38 days vs 8.92 +/- 2.59 days, p = 0.0001), had a lower percentage of wound infections, and had a shorter time for fever to subside (25.79 +/- 11.45 vs 39.46 +/- 17.47 hrs, p = 0.003).

Conclusion: Although management of TOA consists of conservative medical treatment with antibiotics, it is now widely accepted that surgical intervention should be pursued early after the diagnosis. Open laparoscopy seems to be a good alternative to traditional laparotomy in managing these patients.