Laparoscopy versus open surgery for management of tubo-ovarian abscess

Background: Pelvic inflammatory disease (PID) may be complicated by a tubo-ovarian abscess (TOA), which is an inflammatory mass involving the fallopian tube, ovary, and, occasionally, other adjacent pelvic organs (eg, bowel, bladder); typically occurs as a complication of PID. Aim of the study: to evaluate the surgical outcomes after laparoscopy compared with laparotomy in patients with tubo-ovarian abscess. Patient and methods: This prospective cohort study included 60 female patients diagnosed with tubo-ovarian abscess (TOA) divided into two groups (1,2). The study was conducted at the Department of Gynecology and Obstetrics, Al-Azhar University Hospital, Damietta. Results: There were Significant differences between the two groups regarding the type of procedure performed (p=0.035), with drainage being more common in the laparoscopic group (60% vs. 46.7%) and hysterectomy with bilateral salpingo-oophorectomy (BSO) performed only in the laparotomy group (20%). The laparoscopic group had a significantly shorter operative time (91.73±4.69 minutes vs. 112.47±6.17 minutes, p≤0.001). Conclusions: the current study demonstrates that laparoscopic management of tubo-ovarian abscess offers significant perioperative and postoperative advantages over laparotomy. laparoscopic surgery should be considered a preferred approach in suitable cases of tubo-ovarian abscess that need drainage. Further large-scale, multicenter studies are recommended to validate and generalize these results.