Objective To evaluate the short-term morbidity in Borderline Ovarian Tumor (BOT) patients who underwent laparoscopic (LPS) vs. open abdominal laparotomic (LPT) surgery.

Methods We retrospectively analyzed data of consecutive patients treated for primary diagnosis of apparent early stage BOT at Del Ponte Hospital (Varese–Italy) between January 2004 and December 2019. Both radical and fertility-sparing treatments were included in our investigation. Demographic characteristics, operative outcomes and 30-day complications were evaluated and compared between the two surgical approaches.

Results We included data of 128 patients, 84 LPS and 44 LPT. Fifty-seven patients underwent fertility sparing surgery (LPS=31, LPT=26) while 71 patients underwent radical treatment (LPS=53, LPT=18, p=0,17). When comparing LPS vs LPT, median age at surgery was 45,5 vs 59 years old (p<0.001), with 38,09% vs 59,9% patients in menopausal status, respectively (p=0,02). Ten (11,9%) and 14 (31,81%) patients had previous open abdominal/pelvic surgery in the LPS and LPT groups, respectively (p=0,0061). Charlson Comorbidity Index >3 was found in 5 (5,95%) vs. 15 (34,1%) patients (P=0,002). No significant differences were found in terms of parity, previous Caesarean section, previous minimally invasive abdominal/pelvic surgery, and race. Regarding the short-term morbidity, LPS was associated with less blood loss (50 ml vs 200 ml, p=0,01), need for perioperative blood transfusions (0% vs. 6,82%, p=0,005) and in-hospital complications (0% vs. 4,55%, p=0,04).

Conclusions Because of the favorable surgical outcomes, LPS should be considered the standard surgical approach for the treatment of patients with primary diagnosis of early stage BOT.