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
Observational 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 OBJECTIVE: To 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. DESIGN: Retrospective study of women undergoing laparoscopic treatment of intestinal DIE (Canadian Task Force classification II-3). SETTING: Tertiary referral private hospital. INTERVENTIONS: We 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 RESULTS: Patients 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). CONCLUSION: Implementation 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 Laparoscopy Length of Stay Length of Stay Adult Adult Brazil Brazil Endometriosis Endometriosis Endometriosis Female Female Humans Humans Intestinal Diseases Intestinal Diseases

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 ]

References (46)

Cited by (11)

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License: CC0 · commercial use OK