Follow-up of laparoscopic treatment of stage III–IV endometriosis

Mauro Busacca, Busacca M, M Busacca, Bianchi S, Stefano Bianchi, S Bianchi, Agnoli B, B Agnoli, Benedetta Agnoli, Massimo Candiani, M. Candiani, C. Calia, Calia C, S. De Marinis, De Marinis S, Vignali M, M. Vignali
The Journal of the American Association of Gynecologic Laparoscopists · 1999 · vol. 6(1) , pp. 55–58 · doi:10.1016/s1074-3804(99)80041-3 · PMID:9971852 · W2041014199
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This study evaluated the outcomes of laparoscopic surgery for stage III-IV endometriosis, focusing on recurrence rates and patient satisfaction.

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Abstract

Study objectiveTo evaluate the efficacy of conservative laparoscopic surgery in a series of patients with stage III-IV endometriosis.DesignProspective study (Canadian Task Force classification II-1).SettingUniversity-affiliated hospital.PatientsAll 141 women who underwent conservative operative laparoscopy for stage III-IV endometriosis between January 1993 and December 1996 and were followed for a minimum of 6 months.InterventionsLaparoscopic procedures performed with scissors, bipolar coagulation, and hydrodissection.Measurements and main resultsClinical examination, transvaginal ultrasonography, and pain questionnaire were scheduled every 6 months postoperatively. The cumulative proportion of pregnant patients and cumulative recurrence rate were calculated by Kaplan-Meier method. Twenty-five women (44%) with infertility became pregnant. Twenty-three (51%) had stage III and two (16.7%, p <0.05) had stage IV endometriosis. The 24-month cumulative pregnancy rate was 57.5%. Thirty-one women (22%) reported pain recurrence during follow-up. Five (3.5%) recurrences were confirmed by histologic examination and eight (5.7%) were documented only by clinical and ultrasonographic findings. No recurrence occurred in the first 6 months of follow-up.ConclusionOperative laparoscopy seems to be effective treatment for stage III endometriosis. A larger series with longer follow-up is necessary to clarify its role in the management of stage IV disease. (J Am Assoc Gynecol Laparosc 6(1):55-58, 1999)

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Laparoscopy Adult Endometriosis Endometriosis Endometriosis Female Humans Pelvic Pain Pelvic Pain Pregnancy Prospective Studies Recurrence

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