Choosing the right technique for deep endometriosis

Nisolle, Michelle; Brichant, Géraldine; Tebache, Linda

doi:10.1016/j.bpobgyn.2019.01.010

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…The rate of total complications (immediate and late) observed by us (16.67%) was similar to that of other studies, evidencing rates of complications reaching up to one in three procedures performed 6,10–13 . Considering the nature of these complications, transfusion, colostomy, infection, fistula, as reported by us, are also in agreement with the literature 14 . A review of 34 studies (1889 women) showed a complication rate of 22.2%, being the most prevalent complication, the same as in our series 4 .…”

Section: Discussionsupporting

confidence: 92%

Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment

Yela

Vitale

Vizotto

et al. 2021

J of Obstet and Gynaecol

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Aim To evaluate the frequency of complications and factors associated with the recurrence of endometriosis in women with deep infiltrating endometriosis (DIE) undergoing surgical treatment. Methods A retrospective observational cohort study with 72 women who underwent surgery and followed up by DIE at the University of Campinas from 2007 to 2017. The variables analyzed were clinical characteristics, use and type of drug treatment before and after surgery, operative time and complications inherent to the procedure, as well as the recurrence of lesions on imaging. Results The mean age of women was 39.7 ± 6.3 years and the mean follow‐up was 4.56 ± 2.60 years. Complications were reported in 16.6% of surgeries and recurrence of lesions in 34.7%. The risk of intraoperative complications was higher in the presence of lesions of the bowel and in those who used intramuscular progestin before surgery. A higher risk of recurrence was observed among those who did not use hormonal treatment or used a levonorgestrel‐releasing intrauterine device (LNG‐IUD) in the postoperative period. Conclusion Women with DIE have a high rate of complications during surgical treatment and a higher risk of recurrence when they did not receive hormonal treatment or when treated with LNG‐IUD after surgery.

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Section: Discussionsupporting

confidence: 92%

Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment

Yela

Vitale

Vizotto

et al. 2021

J of Obstet and Gynaecol

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“…All forms of endometriosis are challenging to treat; however, surgical complexity and requirement for advanced expertise is particularly high for deep endometriosis. Techniques such as superficial and deep rectal shaving and nerve sparing intestinal dissection are important considerations [38–41]. Future studies will require standardized collection of these endometriosis phenotypic presentation and surgical approach details to parse out adequately whether there has been shift over time in inpatient procedures toward women with more surgically complex endometriosis presentation that may have previously been mis- or undiagnosed.…”

Section: Discussionmentioning

confidence: 99%

National trends in inpatient endometriosis admissions: Patients, procedures and outcomes, 2006−2015

Estes

Soliman

Epstein³

et al. 2019

PLoS ONE

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IntroductionDespite guidance towards minimally invasive, outpatient procedures for endometriosis, many patients nonetheless receive inpatient care. Our objective was to assess trends in patient and hospital characteristics, surgical complications and hospital charges for women with an endometriosis-related inpatient admission in the United States.MethodsWe conducted a pooled cross-sectional analysis of Healthcare Cost and Utilization Project Nationwide Inpatient Sample data. Visits were stratified into three time-period-defined cohorts (2006–2007, 2010–2011, and 2014 through the first three quarters of 2015). Visits were included if the patient was aged 18–49 years and the primary diagnosis code was for endometriosis (International Classification of Diseases, 9th Revision code 617.xx). We evaluated counts of inpatient admissions and rates of patient and hospital characteristics.ResultsThe number of inpatient admissions with a primary diagnosis code for endometriosis decreased by 72.8% from 2006 to 2015. At the same time, among those admitted for inpatient care for endometriosis, the proportions who had Medicaid insurance and multiple documented comorbidities increased. From 2006 to 2015, mean total hospital charges increased by 75% to $39,662 in 2015 US dollars, although average length of stay increased by <1 day.ConclusionsThe number of inpatient admissions with a primary diagnosis of endometriosis decreased over the past decade, while surgical complications and associated hospital charges increased. The share of patients with multiple comorbidities increased and an increasing proportion of inpatient endometriosis admissions were covered by Medicaid and occurred at urban teaching hospitals. These findings suggest a demographic shift in patients receiving inpatient care for endometriosis towards more complex, vulnerable patients.

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“…При цьому в разі повторної лапароскопії «second look» через 6 місяців прогресування захворювання виявлялося у 45% обстежених, а покращення -у 22% пацієнток. Приблизно 20% жінок не відзначали покращення після операції з приводу ендометріозу [19,28].…”

Section: ефективність хірургічного лікування ендометріозуunclassified

Modern views on endometriosis surgery. Literature review

Chernyak

Korchynska

2021

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Endometriosis is a disease associated with the presence of tissue morphologically similar to the endometrium outside the uterine cavity and it is an important medical and social problem. Statistical analysis of the endometriosis prevalence is complicated by polymorphism of manifestations a gradual increase of symptoms and a long period of time from the first symptoms to diagnosis. Manifestations of endometriosis are chronic pain, algodismenorea, dyspareunia, decreased fertility. All these manifestations worsen the quality of life and do not allow a woman to realize her reproductive potential. The most common forms of endometriosis are superficial peritoneal endometriosis, endometrioid ovarian cysts and deep infiltrative endometriosis. Treatment tactics depends on the form and stage of disease, woman's age, presence or absence of reproductive plans, previous treatment. It is possible to use both medical and surgical methods of treatment. Surgical methods can be organ-preserving and radical. The optimal surgical approach should weigh the risks of the surgery itself and the likelihood of recurrence in the radicalism absence. Modern techniques of surgical intervention are considered as one of the main methods of endometriosis treatment. Severe forms of endometriosis are a serious challenge for the surgical team, as chronic inflammation and adhesions alter the normal pelvis anatomy. Such operations often require the involvement of surgeons, urologists and other specialists, and the decision about final operation scope is made during the operation. Endometriosis surgery aims at the maximum possible in each case, the removal of pathological foci, which leads to relief of pain and increase the likelihood of reproductive plans. This article describes the rational scope of surgical interventions and optimal strategies for the management of patients with various forms of endometriosis. The data of international researches of efficiency of various methods of surgical interventions, influence of degree of radicalism on a disease course, probability of recurrence and quality of patient’s life are resulted.

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Choosing the right technique for deep endometriosis

Cited by 10 publications

References 39 publications

Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment

Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment

National trends in inpatient endometriosis admissions: Patients, procedures and outcomes, 2006−2015

Modern views on endometriosis surgery. Literature review

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