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Comparison of CO2 laser laparoscopy with laparotomy for treatment of endometriomata
G D Adamson1, L L Subak, D J Pasta
1Department of Gynecology and Obstetrics, Stanford University School of Medicine, California.
Objective:
To assess the effectiveness of laparoscopy versus laparotomy in the treatment of endometriomata.
Design:
Controlled study using data prospectively tabulated.
Setting:
Treatment performed by senior author in a referral reproductive endocrinology and surgery private practice.
Patients:
One hundred infertile women were diagnosed with endometriomata.
Intervention:
Forty-eight women were treated with CO2 laser laparoscopy (laparoscopy group) and 52 women were treated with CO2 laser or nonlaser laparotomy (laparotomy group).
Main Outcome Measure:
The hypothesis that laparoscopy group pregnancy rates (PRs) would be equal to or greater than laparotomy group was formulated before data analysis but after data tabulation.
Results:
The 1 and 3-year life table estimated cumulative PRs +/- SE were 0.30 +/- 0.07 and 0.52 +/- 0.09 for laparoscopy group and 0.23 +/- 0.06 and 0.46 +/- 0.09 for laparotomy group (Breslow P = 0.48). Monthly fecundity over 3 years was 2.4% for laparoscopy group and 2.0% for laparotomy group.
Conclusions:
Laparoscopy with CO2 laser can be a safe and effective modality for treating endometriomata.