[Early postoperative complications in a multidisciplinary surgical center exclusively dedicated to endometriosis: A 491-patients series]

H. Roman, Horace Roman, Isabella Chanavaz‐Lacheray, I Chanavaz-Lacheray, Chanavaz-Lacheray I, D. Forestier, Forestier D, E. Magne, Magne E, Celhay O, O. Celhay, G. Pasticier, Pasticier G, Susperregui J, José Manuel Susperregui, J Susperregui, Merlot B, B Merlot, Benjamin Merlot
Gynecologie, obstetrique, fertilite & senologie · 2020 · vol. 48(6) , pp. 484–490 · doi:10.1016/j.gofs.2020.03.009 · PMID:32173597 · W3011466199
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This study analyzed 491 endometriosis surgeries performed at a specialized center, finding 12 rectovaginal fistulas and 18 other major complications, with multidisciplinary teams managing complex cases.

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Abstract

OBJECTIVE: The objective of our study is to present the activity volume and postoperative complications in a center exclusively destined to endometriosis surgery. METHODS: Retrospective mono-centric study analyzing data collected prospectively in patients surgically managed for endometriosis from September 2018 to August 2019. RESULTS: Four hundred and ninety-one patients underwent surgery for endometriosis during 12 consecutive months: 268 for colorectal localizations (54.6%), 51 for endometriosis of the urinary tract (10.4%), 17 for nodules of ileum and right colon (3.5%), 43 for nodules of parametriums (8.8%), 12 for nodules of sacral roots and sciatic nerves (2.4%), 7 for diaphragmatic localizations (1.4%). Among 268 patients with colorectal endometrioses, of which 48.1% concerned the low and mid rectum, shaving was performed in 102 cases, disc excision in 96 cases and colorectal resection in 100 cases. Stoma was performed in 13.1% of the cases. Patients could have 2 different procedures for multiple colorectal nodules. One hundred and ninety-nine ovarian endometriomas were managed by plasma energy ablation in 64.8%, sclerotherapy in 11.1%, cystectomy in 13.1%, oophorectomy in 11.1%. Major postoperative complications included 12 rectovaginal fistulas, while 18 other surgical procedures were carried out for various complications. In all, 38.1% of procedures involved a general surgeon and 5.3% an urologist. CONCLUSION: The creation of centers exclusively destined to endometriosis surgery allows the multidisciplinary management of a high number of patients, with an over-representation of severe forms and rare locations of the disease, followed by satisfactory complication rates.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Interdisciplinary Communication Interdisciplinary Communication Postoperative Complications Adult Adult Colonic Diseases Colonic Diseases Colonic Diseases Endometriosis Endometriosis Female Female Humans Humans Postoperative Complications Postoperative Complications Rectal Diseases Rectal Diseases Rectal Diseases

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