Short-term outcome of fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis performed in a tertiary referral center

• Published in: Fertility and sterility Vol. 93; no. 1; pp. 39 - 45
• Main Authors: Pandis, George K., M.R.C.O.G, Saridogan, Ertan, Ph.D., M.R.C.O.G, Windsor, Alastair C.J., M.D., F.R.C.S, Gulumser, Cagri, M.D, Cohen, C. Richard G., M.D., F.R.C.S, Cutner, Alfred S., M.D., M.R.C.O.G
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2010; Elsevier
• Subjects: Adult; Biological and medical sciences; complications; deeply infiltrating; Digestive system. Abdomen; endometriosis; Endometriosis - physiopathology; Endometriosis - surgery; Endoscopy; excision; Female; Female genital diseases; Fertility; Gynecology. Andrology. Obstetrics; Hospitals, University; Humans; Infertility, Female - etiology; Infertility, Female - physiopathology; Infertility, Female - prevention & control; Internal Medicine; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Laparoscopy - adverse effects; Length of Stay; London; Medical sciences; Non tumoral diseases; Obstetrics and Gynecology; Patient Care Team; Pelvis; Retrospective Studies; Time Factors; Treatment Outcome; London; endometriosis; excision; deeply infiltrating; Laparoscopy; complications; Short term; Prognosis; Excision; Gynecology; Endometriosis; Obstetrics; Female genital diseases; Pelvic cavity; Fertility; Uterine diseases; Complication; Endoscopy
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2008.09.051

Objective To examine the short-term surgical outcomes in women undergoing fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis. Design Retrospective cohort study. Setting Tertiary referral center for treatment of endometriosis, a university teaching hospital, London, United Kingdom. Patient(s) A total of 177 women who underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis between January 1, 2006, and December 31, 2007. Intervention(s) Eligible women were identified from the surgeons' database, and their medical notes were reviewed. Data from preoperative assessment, surgery, and postoperative outcomes were analyzed. Main Outcome Measure(s) Complication rate. Result(s) One hundred seventy-seven women underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis including excision of uterosacral ligaments (43, 24.3%), excision of rectovaginal septum (56, 31.6%), rectal shave (56, 31.6%), disk excision (7, 4%) or bowel resection (15, 8.5%). The median operative time was 95 minutes with a range of 30 to 270 minutes (interquartile range 75–120 minutes). Overall, complications developed in 18 women (10.2%). In 12 (6.8%) of these only uncomplicated pyrexia developed whereas significant intraoperative and/or postoperative complications developed in the remaining 6 (3.4%). Women spent a median of 2 days recovering in hospital (range 1–7, interquartile range 2–3 days). Conclusion(s) Fertility-sparing laparoscopic excision of deeply infiltrating endometriosis appears to be safe with a low short-term complication rate.