Fast-Track Surgery in Intestinal Deep Infiltrating Endometriosis

Kondo W, William Kondo, Reitan Ribeiro, Monica Tessmann Zomer, Zomer MT
Journal of Minimally Invasive Gynecology · 2013 · vol. 21(2) , pp. 285–290 · doi:10.1016/j.jmig.2013.09.006 · PMID:24075838 · W2130420833
article OA: closed CC0 ⤵ 11 in-corpus citations
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This paper examines the efficacy and safety of fast-track surgery for patients with deep infiltrating endometriosis of the intestine.

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Abstract

Study objectiveTo evaluate the length of hospital stay (LOS) and the readmission rate in patients undergoing laparoscopic surgery to treat intestinal deep infiltrating endometriosis (DIE) with application of the concepts of fast-track surgery.DesignRetrospective study of women undergoing laparoscopic treatment of intestinal DIE (Canadian Task Force classification II-3).SettingTertiary referral private hospital.InterventionsWe evaluated 161 women who underwent laparoscopic surgery between January 2010 and April 2013 for complete treatment of intestinal DIE, via either conservative surgery (rectal shaving, mucosal skinning, or anterior disk resection) or radical surgery (segmental bowel resection). After surgery, all specimens were sent for pathologic examination to confirm the presence of endometriosis.Measurements and main resultsPatients were divided into 2 groups according to type of surgery (conservative [n = 102] or radical [n = 59]), and LOS and readmission rate were measured in both groups. Median LOS was shorter in the conservative group compared with the segmental bowel resection group (19 vs 28 hours; p < .001). Ninety-two patients (90.2%) in the conservative surgery group were discharged to home on the first postoperative day, compared with only 38 patients (64.4%) in the segmental bowel resection group. Overall, the readmission rate was low (3.1%): 6.8% in the segmental bowel resection group and 1% in the conservative group (p = .04; odds ratio, 7.34; 95% confidence interval, 0.8-67.3); however, the need for repeat operation was similar in both groups (3.4% vs 1%; p = .28; odds ratio, 3.54; 95% confidence interval, 0.31-39.95).ConclusionImplementation of fast-track concepts in the laparoscopic treatment of intestinal DIE resulted in a short LOS and low readmission rate in both the segmental bowel resection and conservative surgery groups.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Intestinal Diseases Laparoscopy Laparoscopy Length of Stay Adult Brazil Endometriosis Endometriosis Female Humans Intestinal Diseases Intestinal Diseases Retrospective Studies Severity of Illness Index 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 (46)

Cited by (11)

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