ObjectiveTo compare the operative outcomes, postoperative pain, and subsequent convalescence after laparoendoscopic single-site surgery (LESS) or conventional laparoscopic surgery for adnexal preservation.Study designFrom December 2009 to September 2010, 63 patients underwent LESS (n = 33) or a conventional laparoscopic surgery (n = 30) for cyst enucleation. The overall operative outcomes including postoperative pain measurement using the visual analog scale (VAS) were evaluated (time points 6, 24, and 24 hours). The convalescence data included data obtained from questionnaires on the need for analgesics and on patient-reported time to recovery end points.ResultsThe preoperative characteristics did not significantly differ between the two groups. The postoperative hemoglobin drop was higher in the LESS group than in the conventional laparoscopic surgery group (P = 0.048). Postoperative pain at each VAS time point, oral analgesic requirement, intramuscular analgesic requirement, and the number of days until return to work were similar in both groups.ConclusionIn adnexa-preserving surgery performed in reproductive-age women, the operative outcomes, including satisfaction of the patients and convalescence after surgery, are comparable for LESS and conventional laparoscopy. LESS may be a feasible and a promising alternative method for scarless abdominal surgery in the treatment of young women with adnexal cysts
. Clinical characteristics, treatment results and follow-up data for 79 women were collected.
ResultsThe mean age at operation was 18.5 year age, and in 5 cases (6.3%) the operation was performed at ≤ 15 year age. Müllerian anomalies were accompanied in 6 cases (7.6%). Seventy-nine per cent of patients had pain associated symptoms such as dysmenorrhea, non cyclic pelvic pain, and gastrointestinal pain. Endometriosis was found to be stage I in 20.3% of patients, stage II in 7.6% of patients, stage III in 40.5% of patients and stage IV in 31.6% of patients. We could not fi nd any recurrence in patients with stage I and II endometriosis, however patients with stage III and IV endometriosis showed recurrence rates of 15.6% and 28.0%, respectively, during the mean follow-up period (33.7 ± 28.5 months). During the 36-month follow-up, the cumulative proportion of subjects free from endometrioma recurrence was 82.5%, but the rate increased as the follow-up period was extended.
ConclusionEndometriosis can occur in adolescents and the recurrence rate is higher in advanced stage. As endometriosis is a progressive disease, early diagnosis and treatment during adolescence may be necessary.
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