Tailoring radicality in demolitive surgery for deeply infiltrating endometriosis
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This paper explores variations in surgical approaches to deeply infiltrating endometriosis, focusing on the extent of tissue removal and its impact.
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Abstract
ObjectiveThe purpose of this study was to compare the outcome of standard extrafascial hysterectomy and tailored radical hysterectomy as a definitive treatment of recurrent deep endometriosis.Study designThis was a descriptive study that comprised 38 patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy between 1989 and 2002 for symptomatic recurrences of deep endometriosis, after>or=1 previous surgical procedures and ovarian suppressive medical treatments. After the operation, all of the patients were given transdermal estradiol. The minimum follow-up time was 24 months.ResultsTwenty-six patients underwent standard extra-fascial hysterectomy (group A), and 12 patients underwent modified radical hysterectomy that included the removal of all deeply infiltrating endometriotic lesions (group B). The recurrence of pain caused by endometriosis occurred in 8 women (31%) of group A and in no patients of group B.ConclusionDefinitive surgery for deep endometriosis should include the removal of the uterus, adnexa, and all surgically accessible deep lesions. As a consequence, the surgeon must be familiar with radical pelvic surgery.
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- Diagnostic Accuracy of Transvaginal Sonography for Deeply Infiltrating Endometriosis and Pouch of Douglas Obliteration in the Presence or Absence of Ovarian Endometrioma 2023
- Excisional endometriosis surgery with hysterectomy and bilateral salpingo-oophorectomy versus excisional endometriosis surgery alone for pelvic pain associated with deep endometriosis 2023
- Radical Endometriosis Surgery: A Review of Surgical Techniques and Associated Challenges 2022
- Morphological and molecular features of recurrent endometrioid ovarian cysts 2022
- Hystérectomie dans un contexte d’endométriose profonde 2022
- Reproductive and postsurgical outcomes of infertile women with deep infiltrating endometriosis 2022
- Reoperation and pain-related outcomes after hysterectomy for endometriosis by oophorectomy status 2022
- Treatment of endometriosis: a review with comparison of 8 guidelines 2021
- Mapping of endometriosis in patients with unilateral endometrioma 2021
- Nerve-Sparing Modified Radical Hysterectomy for Severe Endometriosis and Complex Pelvic Pathology 2020
- Comparison of Laparoscopic Hysterectomy in Patients with Endometriosis with and without an Obliterated Cul-de-sac 2019
- Multidisciplinary laparoscopic management of deep infiltrating endometriosis from 2010 to 2017: A retrospective cohort study 2019
- Oligo-anovulation is not a rarer feature in women with documented endometriosis 2018
- Surgical challenges in the treatment of perimenopausal and postmenopausal endometriosis 2018
- Current and Emerging Therapeutics for the Management of Endometriosis 2018
- Synthèse des stratégies et prise en charge chirurgicale de l’endométriose, RPC Endométriose CNGOF-HAS 2018
- Treatment Patterns, Complications, and Health Care Utilization Among Endometriosis Patients Undergoing a Laparoscopy or a Hysterectomy: A Retrospective Claims Analysis 2017
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- Measurement of hs-CRP is irrelevant to diagnose and stage endometriosis: prospective study of 834 patients 2014
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- Endometriosis (actualizado en febrero del 2013) 2014
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- Serum and peritoneal interleukin-33 levels are elevated in deeply infiltrating endometriosis 2012
- Abdominopelvic Complications of Endometriosis 2012
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- Récidive de la douleur après chirurgie pour endométriose profonde : pourquoi ? Que faire ? 2012
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