Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications

Minelli, Luca; Ceccaroni, Marcello; Ruffo, Giacomo; Bruni, Francesco; Pomini, Paola; Pontrelli, Giovanni; Rolla, Martino; Scioscia, Marco

doi:10.1016/j.fertnstert.2009.08.035

Cited by 48 publications

(46 citation statements)

References 33 publications

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“…Previous studies have focused on women with advanced stage endometriosis and reported intraoperative complication rates ranging from 0.4% to 5% and a postoperative complication rate ranging from 1.0% to 37.9% . Magrina et al retrospectively investigated 493 women with stage III and IV endometriosis who underwent laparoscopic treatment of endometriosis and reported 2 (0.4%) intraoperative complications, 3 (0.6%) conversions to laparotomy, and 5 (1%) major postoperative complications .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of endometriosis and predictors of major complications: A retrospective cohort study

Clark

Dmello

Griffith

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Patients with advanced endometriosis may be at an increased risk of surgical complications following laparoscopic treatment of endometriosis; however, this relationship has not been examined. We sought to identify predictors of major complications following laparoscopic treatment of endometriosis. Material and methods A retrospective cohort study of women who underwent laparoscopic treatment of suspected endometriosis between 2009 and 2016 within the Division of Minimally Invasive Gynecologic Surgery at Brigham and Women’s Hospital, Boston, MA, USA. Predictors of major perioperative complications were assessed by comparing the characteristics of women who had any major intraoperative or postoperative complication with those of women who had no complication. Results A total of 397 women underwent laparoscopic treatment of suspected endometriosis including excision of superficial endometriosis (55.4%), excision of deep‐infiltrating endometriosis (24.9%), fulguration of endometriosis (38.3%), hysterectomy (23.2%), ovarian cystectomy (35.5%), salpingectomy (18.6%), oophorectomy (15.1%), and bowel resection (1.0%). Women were followed for 60 days following surgery, over which time 18 women (4.5%) had a major perioperative complication. Patient characteristics and preoperative imaging were similar between women with and without complications. Women with advanced endometriosis, including stage III or IV endometriosis, deep‐infiltrating endometriosis, or rectovaginal disease, were more likely to have a complication, though this did not reach statistical significance (77.8% of women with a complication versus 56.7% of women without a complication had advanced endometriosis, P = 0.077). Women who had a complication were more likely to have undergone adhesiolysis or ureterolysis (88.9% of women with a complication versus 52.5% without a complication underwent adhesiolysis, P = 0.002; and 61.1% of women with a complication versus 28.8% without a complication underwent ureterolysis, P = 0.003). The total number of procedures was greater for women who had a complication (4.3 ± 1.2 vs 3.2 ± 1.5, P = 0.003). All other procedure characteristics were similar between women with and without complications. Conclusions Complications following laparoscopic treatment of suspected endometriosis could not be predicted by preoperative patient characteristics or surgical findings of advanced endometriosis. Adhesiolysis, ureterolysis, and an increased number of total procedures may be predictive of perioperative complications, suggesting that surgical complexity as measured by the procedures performed, rather than the disease severity, may increase the risk of a complication compared with women who do not undergo these procedures.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of endometriosis and predictors of major complications: A retrospective cohort study

Clark

Dmello

Griffith

et al. 2019

Acta Obstet Gynecol Scand

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“…The main role of laparoscopy, however, is therapeutic and several studies indicate a significant improvement of symptoms after laparoscopic eradication of all visible implants of DIE. Therefore, precise preoperative imaging of the location and extent of lesions is indispensable to ensure the best therapeutic procedure and treatment planning .…”

Section: Introductionmentioning

confidence: 99%

“…For the definitive diagnosis of DIE, visual inspection of the pelvis by laparoscopy is the gold standard investigation, unless disease is visible in the vagina or elsewhere. Positive histology confirms the diagnosis; but negative histology does not exclude it, in the presence of pathognomonic lesions 15 . The main role of laparoscopy, however, is therapeutic and several studies indicate a significant improvement of symptoms after laparoscopic eradication of all visible implants of DIE 16 . Therefore, precise preoperative imaging of the location and extent of lesions is indispensable to ensure the best therapeutic procedure and treatment planning 17 .…”

Section: Introductionmentioning

confidence: 99%

Accuracy of transvaginal sonography and contrast‐enhanced magnetic resonance‐colonography for the presurgical staging of deep infiltrating endometriosis

Vimercati

Achilarre

Scardapane

et al. 2012

Ultrasound in Obstet & Gyne

113

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“…The left ovary was identified as being markedly adhered to the colon during the patient’s second surgery. A meticulous excision was difficult to perform (22,23), which may have resulted in a trace amount of residual left ovary. The blood supply of the residual ovary tissue may account for the formation of collateral circulation (24).…”

Section: Discussionmentioning

confidence: 99%

Malignant transformation of residual endometriosis following hysterectomy and bilateral salpingo-oophorectomy in a female patient from a family with hereditary non-polyposis colorectal cancer

et al. 2013

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The aim of this study was to report a case of malignant transformation from residual endometriosis following hysterectomy and bilateral salpingo-oophorectomy in a female patient with a positive family history of ovarian and colon cancer resulting from residual endometriosis. A 42-year-old female patient from a family with hereditary non-polyposis colorectal cancer (HNPCC) diagnosed with bilateral ovarian endometriosis underwent a hysterectomy and bilateral salpingo-oophorectomy. Two years later, the patient was diagnosed with malignant ovarian cancer. Histological examination revealed an endometrioid adenocarcinoma with transitions between endometriosis and adenocarcinoma. The patient was diagnosed with ovarian endometrioid carcinoma, at FIGO stage IIC. In future, the family history of female patients with endometriosis should be collected. The association between the malignant transformation of endometriosis and HNPCC should be studied further in a research setting.

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Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications

Cited by 48 publications

References 33 publications

Laparoscopic treatment of endometriosis and predictors of major complications: A retrospective cohort study

Laparoscopic treatment of endometriosis and predictors of major complications: A retrospective cohort study

Accuracy of transvaginal sonography and contrast‐enhanced magnetic resonance‐colonography for the presurgical staging of deep infiltrating endometriosis

Malignant transformation of residual endometriosis following hysterectomy and bilateral salpingo-oophorectomy in a female patient from a family with hereditary non-polyposis colorectal cancer

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