Surgical outcomes of laparoscopic endometriosis surgery: a 6 year experience

Saeed Alborzi, S Alborzi, A Hosseini-Nohadani, Azam Hosseini‐Nohadani, Tahereh Poordast, T Poordast, Zahra Shomali, Z Shomali
Current medical research and opinion · 2017 · vol. 33(12) , pp. 2229–2234 · doi:10.1080/03007995.2017.1362377 · PMID:28760003 · W2741116575
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This 6-year study of 1315 laparoscopic endometriosis surgeries found significant pain reduction, with 33.1% of infertile women achieving spontaneous pregnancy and 25% achieving pregnancy with ART/IUI.

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Abstract

OBJECTIVES: The aim of the present study was to review 6 year experience on the surgical outcomes of laparoscopic endometriosis surgery. METHODS: A cohort study was performed in Shiraz University of Medical Sciences using data from medical records of 1315 cases of patients with endometriosis undergoing laparoscopic surgery with follow-up of 6 to 72 months. RESULTS: This study concerned a cohort of 1315 patients diagnosed with endometriosis operated between April 2010 and April 2016, 1086 (82.5%) of whom were in stage III and IV; 968 (73.61%) had endometrioma (regardless of having deep infiltrative endometriosis [DIE] or peritoneal involvement) and 347 (26.39%) of patients had either DIE or peritoneal involvement without endometrioma. Regarding the patients, unilateral endometrioma was statistically significant in the left ovary (p = .002). One hundred and thirty-three (10.7%) rectal wall, 7 (0.32%) sigmoid colon, 4 (0.18%) vagina, 125 (5.6%) ureter and 33 (1.52) bladder involvements were detected. Prior to operation, the pain VAS score was 8.23 ± 2.03, which decreased to 4.46 ± 2.47 in 93.07% of patients. Fifty-three patients (6.56%) needed reoperation. Sixty-six (33.1%) infertile women had spontaneous pregnancy and 15 (25%) became pregnant using intrauterine insemination (IUI) or assisted reproductive technique (ART) post-operatively. CONCLUSION: Surgical treatment of endometriosis seems to be an effective treatment. DIE can be present in the absence of endometrioma. The rate of left endometrioma is higher due to the pressure effect of the sigmoid colon. Nonetheless, if an expert surgeon performs this procedure, not only the rate of post-operative complications, but also the possibility of recurrence would decrease.

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Outcome instruments

VAS-pain

Condition tags

endometriosisdie_deep_infiltratingendometrioma

MeSH descriptors

Endometriosis Infertility, Female Laparoscopy Adolescent Adult Cohort Studies Endometriosis Female Humans Infertility, Female Laparoscopy Laparoscopy Middle Aged Pregnancy Reproductive Techniques, Assisted Treatment Outcome Young Adult

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References (78)

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