Factors influencing the choice of laparoscopy or laparotomy in pregnant women with presumptive benign ovarian tumors.

摘要

OBJECTIVE: To evaluate the factors associated with physicians' choice of laparotomy or laparoscopy in pregnant women with presumptive benign ovarian tumors. METHODS: Retrospective comparative analysis of pregnant women who underwent laparotomy or laparoscopy for ovarian tumors and who delivered at Samsung Medical Center, Seoul, Korea, between July 1995 and April 2008. RESULTS: Univariate analysis revealed that the following factors had a significant or a borderline significant association with the choice of operation type: maternal age (P=0.044); surgeon type (professor vs clinical fellow; P=0.094); tumor mass size (P=0.081); gestational age (P=0.035); and time since surgery (P<0.001). Multivariate analysis showed that tumor size (P=0.030), gestational age (P=0.027), and time since surgery (P=0.004) were independent factors associated with physicians' choice of laparoscopy or laparotomy for the management of presumptive benign ovarian tumors during pregnancy. CONCLUSIONS: In the latter years of the present study, physicians at the study center preferred the laparoscopic approach for managing presumptive benign ovarian tumors during pregnancy. Furthermore, they preferred this approach to laparotomy for pregnancies at a relatively early gestational age and for treating small tumors.