Multidisciplinary laparoscopic management of deep infiltrating endometriosis from 2010 to 2017: A retrospective cohort study

Demetrio Larraín, Hans Buckel, Jaime Prado, Mario Abedrapo, Iván Rojas
Medwave · 2019 · vol. 19(11) , pp. e7750 · doi:10.5867/medwave.2019.11.7750 · PMID:31999675 · W2995121679
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study of 137 patients found laparoscopic management of deep infiltrating endometriosis to be safe and effective, with high symptom relief and pregnancy rates, but noted longer operative times for bowel involvement.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective cohort study analyzed 137 consecutive patients with histologically confirmed deep infiltrating endometriosis treated between 2010 and 2017 at a reference center, capturing demographics, surgical approaches, complications (graded by Clavien-Dindo), reproductive outcomes, and symptom response via telephone follow-up. All operations were completed laparoscopically without conversion, with most patients reporting severe dysmenorrhea and dyspareunia, frequent uterosacral ligament disease and coexisting ovarian endometrioma, a median operative time of 140 minutes (longer when intestinal procedures were needed), and a 10.9% perioperative complication rate; 58.1% achieved pregnancy and 90% reported significant symptom improvement during a median 24.5-month follow-up. The authors explicitly note limitations including use of a verbal scale for symptom change that complicates comparison across literature terminology, and the variable anatomic distribution of deep infiltrating disease requiring different resections across patients. This paper is centrally about endometriosis — it evaluates multidisciplinary laparoscopic surgical management outcomes for deep infiltrating endometriosis over 2010–2017.

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Abstract

BACKGROUND: Laparoscopy has become the standard of care in the surgical management of deep infiltrating endometriosis (DIE). However, it is a challenging procedure with a high complication rate. Despite the benefits of the minimally invasive approach, DIE resection is often performed by surgeons without adequate training, especially in developing countries like Chile. OBJECTIVE: To asses our experience in the diagnosis and laparoscopic management of DIE during seven years. METHODS: A retrospective cohort study of data including 137 patients with pathology-proven DIE. Surgical and fertility outcomes were evaluated. RESULTS: All procedures were performed laparoscopically without conversion. Dysmenorrhea and dyspareunia were the most common symptoms in 85.4% and 56.9%, respectively. Uterosacral ligaments were the most common DIE location. Endometrioma was present in 48.9% of cases. Median operative time was 140 minutes; however, it was longer in cases requiring bowel surgery (p < 0.0001). The complication rate was 10.9%. Median follow-up was 24.5 months. The pregnancy rate was 58.1% and 90% of patients reported significant symptom relief after surgery. CONCLUSION: Laparoscopic surgical management of DIE is effective and safe but it must be performed in tertiary centers with the availability of multidisciplinary teams.

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Condition tags

dysmenorrheadyspareuniaendometriosisdie_deep_infiltratingendometrioma

MeSH descriptors

Endometriosis Laparoscopy Postoperative Complications Adult Chile Cohort Studies Dysmenorrhea Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Female Follow-Up Studies Humans Laparoscopy Patient Care Team

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