Safety and Effect on Quality of Life of Laparoscopic Douglasectomy with Radical Excision for Deeply Infiltrating Endometriosis in the Cul-de-Sac

Dae Gy Hong, Hong DG, Kim JY, Joo Young Kim, Lee YH, Yoon Hee Lee, Chong GO, Gun Oh Chong, Cho YL, Young Lae Cho, Lee YS, Yoon Soon Lee
Journal of laparoendoscopic & advanced surgical techniques. Part A · 2014 · vol. 24(3) , pp. 165–170 · doi:10.1089/lap.2013.0270 · PMID:24625348 · W2203581127
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Laparoscopic radical excision of deeply infiltrating endometriosis in the cul-de-sac safely improved patient quality of life, particularly pain scores, with severity of disease potentially influencing the degree of HRQOL improvement.

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Abstract

OBJECTIVE: To evaluate the safety and effects on health-related quality of life (HRQOL) of radical excision of deeply infiltrating endometriosis (DIE) in the cul-de-sac. PATIENTS AND METHODS: This study included 390 patients with pathologically proven DIE in the cul-de-sac who underwent laparoscopic surgery between January 2000 and December 2011. The preoperative and postoperative visual analog scale (VAS) pain scores and HRQOL data from the 36-item Short Form (SF-36) questionnaire were recorded in 343 patients. Surgical outcomes, complications, and HRQOL were compared between patients who underwent hysterectomy and those who did not. Data were analyzed using the paired t test, Student's t test, and Pearson's correlation analysis. RESULTS: In the group overall, the VAS pain score and all SF-36 scales improved after surgery. In patients who underwent hysterectomy, all SF-36 scales improved except physical functioning, role-physical, general health, and vitality. In patients who did not undergo hysterectomy, all SF-36 scales improved except general health. There were significant associations between gonadotropin-releasing hormone agonist therapy and SF-36 mental health, SF-36 mental component summary, and oral medication use. The VAS pain score and SF-36 body pain score showed the greatest improvement, and the SF-36 general health score showed the least improvement. Patients who underwent hysterectomy had more severe disease and poorer surgical outcomes than those who did not undergo hysterectomy. CONCLUSIONS: Laparoscopic radical excision of DIE in the cul-de-sac is safe and significantly improves HRQOL, especially in terms of pain. The severity of endometriosis may affect the degree of improvement in HRQOL scores.

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Outcome instruments

VAS-pain

Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Laparoscopy Laparoscopy Pain Pain Quality of Life Adult Endometriosis Endometriosis Female Humans Hysterectomy Hysterectomy Middle Aged Pain Pain Pain Measurement Perioperative Period Surveys and Questionnaires Treatment Outcome

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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 (12)

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