Characteristics and trendsof surgical management on endometriosis: a review of cases from Peking Union MedicalCollege Hospital from 1983 to 2009

：Objective To investigatethe characteristics and trends of surgical management on endometriosis in Peking UnionMedical College Hospital From 1983 to 2009. Methods The medical documents of patients withendometriosis diagnosed by surgical pathology were studied retrospectively in Peking UnionMedical College Hospital (PUMCH). The ratio of different surgical approaches (laparoscopicand laparotomic surgery) and surgical categories (conservative, semi-radical or radicalsurgery) were compared in all the cases with endometriosis to investigated alterationstrends of approaches and methods of surgery. Results Totally integrated records of 13 972patients underwent surgeries on endometriosis were reviewed and consisted of 24. 974% (13972/55 945) of all gynecologic surgeries. 59. 490% of cases (8312/13 972) were treated bylaparoscopic approach, which were significantly higher than the rate of 37.700%(15 824/41973) of laparoscopic approaches in the other gynecologic diseases (P<0.01). Theproportion of laparoscopic surgeries in all endometriosis surgery was 67.31% (947/1407)between 2005 and 2009, which were significantly higher than 55. 98% (510/911) oflaparoscopic surgeries between 2000 and 2004 (P<0.01). Conservative surgery (i.e.,withuterus and ovaries intact) consisted of 64. 014%(8663/13 533) of endometriosis surgeries.The proportion of conservative surgeries was 66. 24% (4176/6304) between 2005 and 2009.The proportion of laparoscopic approaches consisted of 81.10% (7026/8663) of conservativesurgeries and 26. 30% (1281/4870) of semi-radical or radical surgeries (P<0.01).Theaverage number of annual surgeries, the average number of annual laparoscopic surgeriesand its proportion in endometriosis, and the average number of annual conservativesurgeries and its proportion in pelvic endometriosis between 2005 -2009 were all increasedsignificantly than those at range of 1983 to 1999 and 2000 to 2004. The rate of severecomplication 0. 351% (49/13 972) was observed in all endometriosis surgeries. ConclusionSurgery was the major treatment of endometriosis in PUMCH, laparoscopic surgery was themajor approach and conservative surgery was the major surgery type.