Diaphragmatic endometriosis minimally invasive treatment: a feasible and effective approach

Andres Vigueras Smith, Ramiro Cabrera, William Kondo, Helder Ferreira, Hélder Ferreira
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2020 · vol. 41(2) , pp. 176–186 · doi:10.1080/01443615.2019.1702934 · PMID:32053018 · W3006194316
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This review analyzed current data and found minimally invasive surgical treatment for diaphragmatic endometriosis to be safe, effective, and feasible in specialized centers.

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Abstract

The present review aims to analyse the current data available on the feasibility, safety and effectiveness of the minimally invasive surgical (MIS) treatment of diaphragmatic endometriosis (DE). Through the use of PubMed and Google Scholar database, we conducted a literature review of all available research related to diagnosis and treatment of DE, focussed on the minimally invasive techniques. The studies were selected independently by two authors according to the aim of this review. DE is an under-diagnosed disease affecting between 0.1% and 1.5% of fertile women. It is predominantly multiple, asymptomatic and highly associated with pelvic disease in about 50–90%. MIS techniques seems to be safe, effective and feasible in tertiary advanced endometriosis centre, offering definitive advantages in terms of hospital stay, post-operative pain and return to normal activity by using several surgical techniques as hydro-dissection plus resection, laser CO2 vaporisation, electrical fulguration, Sugarbaker peritonectomy, partial (shaving) and full-thickness diaphragmatic resection. Symptoms control range from 85% to 100%, with less than 3% of conversion, peri-operative complications and recurrence rate. All cases must be performed by multidisciplinary teams including at least a gynaecologist, thoracic surgeon and anaesthetist. The lack of prospective evaluation of DE interferes with the understanding about the natural history of disease and treatment results. Therefore, the development of adequate evidence-based recommendations about diagnosis, management and follow-up is difficult at this moment.

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Condition tags

endometriosisthoracic_endometriosis

MeSH descriptors

Diaphragm Diaphragm Diaphragm Endometriosis Endometriosis Endometriosis Endometriosis Minimally Invasive Surgical Procedures Minimally Invasive Surgical Procedures Minimally Invasive Surgical Procedures Minimally Invasive Surgical Procedures Female Humans Patient Care Team Patient Care Team Treatment Outcome

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (36)

Cited by (21)

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License: CC0 · commercial use OK