Laparoscopic Approach has Benefits in Gynecological Emergencies - Even for Massive Hemoperitoneum.

OBJECTIVE The purpose of this study is to compare the laparoscopic with the open approach in hemoperitoneum of gynecological origin. MATERIALS AND METHODS Retrospective study of patients admitted to a tertiary emergency hospital between January 2013 - January 2015. RESULTS There were 56 patients, 27 in the laparoscopic group (LG) and 28 in the open group (OG). The gynecological emergency was a ruptured ovarian cyst in 20 (74%) versus 17 (59%) cases, and an ectopic pregnancy with tubal rupture in 7 (26%) versus 12 (41%) patients in both the laparoscopic and open approaches, respectively. The main outcome - mean intraoperative hemoglobin decrease - was 1.5 +- 1.2 g/dl in the laparoscopic and 1.9 ‚+-1.4 in the open approach (p=0.344). There were no differences regarding red blood transfusion rate, needs for analgesics, postoperative complications and in-hospital stay. CONCLUSION The laparoscopic approach in acute abdomen of gynecologic origin is non-inferior to open surgery.