Laparoscopic Compared With Open Surgery for Severe Pelvic Inflammatory Disease and Tubo-Ovarian Abscess.
Abdominal Abscess
/ surgery
Adolescent
Adult
Aged
Female
Gynecologic Surgical Procedures
/ adverse effects
Humans
Japan
/ epidemiology
Laparoscopy
/ adverse effects
Length of Stay
Logistic Models
Middle Aged
Pelvic Inflammatory Disease
/ surgery
Postoperative Complications
/ epidemiology
Propensity Score
Quality of Life
Retrospective Studies
Young Adult
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
entrez:
29
5
2019
pubmed:
29
5
2019
medline:
25
2
2020
Statut:
ppublish
Résumé
To compare operative outcomes of laparoscopic surgery compared with laparotomy in patients with moderate to severe pelvic inflammatory disease (PID). Using the Diagnosis Procedure Combination database, a national inpatient database for acute-care inpatients in Japan, we performed a large, nationwide retrospective cohort study. We identified all patients aged 18 years or older who were diagnosed with PID with or without tubo-ovarian abscess and were admitted to a participating hospital from July 2010 to March 2016. We excluded patients who were pregnant, had cancer, or for whom data were missing. We compared outcomes between patients who underwent laparoscopic surgery compared with laparotomy. Propensity score-matched analyses were performed to compare operative outcomes including postoperative length of stay, surgical complications, in-hospital deaths, and revision surgery. Of 27,841 patients with PID, 4,419 (15.9%) underwent surgical intervention. From among 749 women undergoing laparoscopy and 3,670 women undergoing laparotomy for PID, 740 pairs were created for propensity score matching. The laparoscopic group had shorter operation duration (125 vs 166 min), fewer blood transfusions (4.7% vs 10.0%), and shorter length of hospital stay (median 5 days vs 7 days; all P<.001) compared with the laparotomy group. There were no significant differences between groups for in-hospital deaths, surgical complications, and revision surgery. Laparoscopic surgery may have clinical advantages over laparotomy in patients diagnosed with severe PID.
Identifiants
pubmed: 31135738
doi: 10.1097/AOG.0000000000003259
pii: 00006250-201906000-00021
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1224-1230Références
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