Laparoscopic En Bloc Right Diaphragmatic Peritonectomy for Diaphragmatic Endometriosis According to the Sugarbaker Technique

Vito Chiàntera, Vito Chiantera, Margherita Dessole, Dessole M, Marco Petrillo, Petrillo M, Alessandro Lucidi, Frangini S, Sergio Frangini, Francesco Legge, Giovanni Scambia, Sylvia Mechsner
Journal of Minimally Invasive Gynecology · 2016 · vol. 23(2) , pp. 198–205 · doi:10.1016/j.jmig.2015.09.020 · PMID:26454194 · W2262795940
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This paper describes the laparoscopic en bloc resection of diaphragmatic endometriosis using the Sugarbaker technique.

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Abstract

STUDY OBJECTIVE: To evaluate the feasibility of a novel laparoscopic procedure for complete eradication of diaphragmatic endometriosis (DE). DESIGN: A retrospective multicenter study (Canadian Task Force Classification II-2). SETTING: University tertiary referral centre. PATIENTS: A consecutive series of 9 women with DE. INTERVENTIONS: Laparoscopic en bloc eradication using Sugarbaker's peritonectomy technique with or without diaphragmatic resection for DE. All surgical procedures were performed by the same surgeon in 2 tertiary referral centers (Charitè University, Berlin, Germany, and Catholic University of the Sacred Heart, Foundation John Paul II, Campobasso, Italy). MEASUREMENTS AND MAIN RESULTS: Rate of conversion to laparotomy, perioperative outcomes, intra- and postoperative complications, and recurrence rate. The procedures were successfully performed in all patients laparoscopically without conversion to laparotomy. All patients also presented with multiple endometriotic lesions in the Morison pouch, and in 3 cases a deep infiltration of the right diaphragm was observed that required partial diaphragmatic resection. In 2 women, pulmonary nodules were also detected, and lung laparoscopic resection was attempted to eradicate the disease. A chest drain was placed in 7 women and was removed after a median time of 6 days (range, 4-10 days). No intra- or postoperative complications were recorded. To complete the diaphragmatic peritonectomy, the median operative time required was 180 minutes (range, 90-240 minutes). The median estimated blood loss was 100 mL (range, 50-300 mL), and the median hospital stay was 10 days (range, 5-17 days). After a median follow-up of 6 months, we observed symptomatic relief for all study patients without major surgery-related morbidity. In 1 woman, laparoscopic adhesiolysis was performed after 18 months from surgery without signs of recurrent endometriosis. CONCLUSION: Laparoscopic en bloc eradication of DE with Sugarbaker's peritonectomy is highly effective in the management of symptomatic DE, with no major intra-/postoperative complications and very favorable perioperative outcomes.

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Condition tags

endometriosisthoracic_endometriosis

MeSH descriptors

Diaphragm Endometriosis Laparoscopy Laparoscopy Laparoscopy Laparotomy Muscular Diseases Postoperative Complications Adult Adult Diaphragm Diaphragm Diaphragm Endometriosis Endometriosis Endometriosis Female Female Germany Germany

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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