Surgical Outcomes of Urinary Tract Deep Infiltrating Endometriosis

Darwish, Basma; Stochino-Loi, Emanuela; Pasquier, Geoffroy; Dugardin, F.; Defortescu, G.; Abo, Carole; Roman, Horace

doi:10.1016/j.jmig.2017.06.005

Cited by 33 publications

(37 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 Surgical treatment in these women often requires extensive dissection and in some cases, bowel, bladder, or ureteral surgery, all of which may increase the risk of surgical complications. [5][6][7][8] Work evaluating women with American Society for Reproductive Medicine (ASRM) stage III or IV endometriosis suggests that complications may be more likely to occur when concomitant bowel surgery or a hysterectomy is performed. 9,10 Studies of women with deep-infiltrating endometriosis (DIE) have also shown that major complications are more likely to occur when the bowel is involved and/or bowel surgery becomes necessary, in particular when segmental resection is performed.…”

Section: Introductionmentioning

confidence: 99%

“…Women with advanced endometriosis are surgically complex due to the potential for dense adhesions, inflammation, distorted pelvic anatomy, and gastrointestinal or genitourinary tract involvement . Surgical treatment in these women often requires extensive dissection and in some cases, bowel, bladder, or ureteral surgery, all of which may increase the risk of surgical complications …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Clark

Dmello

Griffith

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

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

View full text Add to dashboard Cite

show abstract

“…We defend the principles of conservative surgery to reduce the risk of postoperative complications and functional sequelae. Conservative surgery, being performed in most of our patients with deep endometriosis infiltrating the bowel [14] and ureters [15], results in high postoperative pregnancy rates, most of which are the result of spontaneous conception, as well as a low complication rate. Reduction of health expenditure needs to be demonstrated.…”

mentioning

confidence: 99%

Swimming Against the Stream: Is Surgery Worthwhile in Women with Deep Infiltrating Endometriosis and Pregnancy Intention?

Darwish

Chanavaz-Lacheray

Roman

2018

Journal of Minimally Invasive Gynecology

Self Cite

View full text Add to dashboard Cite

“…This is one of the most important processes during TLH . However, quick localization of the ureter requires time to master, and the ureter could be difficult to detect, even for experts, in cases with high adhesion, for example, due to endometriosis . In this study, we investigated whether we could detect ureters by abstracting various types of features from surgical movies. suture string detection.…”

Section: Introductionmentioning

confidence: 99%