Clinical outcomes following surgical management of deep infiltrating endometriosis: a retrospective cohort study

Abstract

Objectives: The main aim of the study was to evaluate severe post-operative complications following deep endometriosis surgery in a tertiary referral centre.Methods: This is a retrospective cohort study that included women who had surgery for deep infiltrating endometriosis between 1st January 2013 and 31st December 2019. Endometriosis was diagnosed based on clinical, imaging and histological parameters. We evaluated the rates of post-operative complications, potential risk factors for such complications and postoperative pregnancy rates.Results: A total of 165 patients were included in the final analysis. The median follow-up was 63 (25 - 106) months. Thirty-seven patients (22.42%) had hysterectomy, 60 (36.81%) had ureterolysis and 44 (26.67%) had colorectal surgery. The overall and severe rates of post-operative complications were 16.20% (n=23) and 2.42% (n=4) respectively. Of the variables assessed, operative time and age were the only statistically significant risk factor for complications on multivariate analysis. Among the women operated on for infertility, 34.5% (n=20/58) got pregnant following surgery with 30% of these spontaneously.Conclusions: This study demonstrates acceptable overall and severe post-operative complications and pregnancy rates after deep endometriosis surgery. This information should help clinicians when counselling women to enable them make an informed choice about their management.