Laparoscopic treatment of endometriosis.
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A multidisciplinary surgical team achieved good clinical outcomes, improved quality of life, and high pregnancy rates in patients with extensive endometriosis through radical, fertility-preserving resection.
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Abstract
Endometriosis can be considered as a chronic disease which is characterized by the presence of ectopic endometrium outside the endometrial cavity and which is associated with symptoms as pelvic pain and infertility. Medical treatment is often not sufficient in patients with moderate to severe endometriosis and deep infiltrative endometriosis (DIE), therefore requiring surgical intervention. Over the past 15 years, we have built a multidisciplinary surgical team to perform a radical but fertility preserving resection of extensive endometriosis with involvement of surrounding organ systems, realizing a good clinical outcome with low complication and recurrence rate, a very good improvement of QOL and a high pregnancy rate. However, for future research evaluating surgical treatment of extensive endometriosis, it is important to reach agreement on study design and on reporting clinical outcome data. A multicenter study with clear patient identification and well defined outcome parameters needs to be set up. Moreover, prevention of DIE with colorectal extension is important, ideally by early identification and management of girls and women at risk. Years of pain and disability as well as a lot of money could be saved when patients, at risk of developing extensive forms of endometriosis could be diagnosed during adolescence.
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Cited by (15)
- Suburethral Endometriosis as Clinical Finding of Extensive Disease 2022
- Laparoscopic Surgery in Adolescent Endometriosis 2020
- Management of endometriosis from diagnosis to treatment: roadmap for the future 2019
- Laparoscopic Surgery for the Management of Endometriosis 2018
- Endometriosis in Hydatid Cysts of Morgagni: A Retrospective Cohort Study of Another Atypical Manifestation of Endometriosis 2017
- The Laparoscopic Management of Endometriosis in Patients with Pelvic Pain 2014
- Transvaginal specimen extraction after laparoscopic bowel resection in deeply infiltrating endometriosis 2014
- Molecular aspects of development and regulation of endometriosis 2014
- A randomized study comparing the side effects and hormonal status of triptorelin and leuprorelin following conservative laparoscopic surgery for ovarian endometriosis in Chinese women 2014
- Video-assisted laparoscopy for the detection and diagnosis of endometriosis: safety, reliability, and invasiveness 2012
- Endometriosis: Diagnosis and Treatment: From Fingernails to the Robot 2012
- The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study 2010
- Laparoscopic Management of Ureteral Endometriosis: The Stanford University Hospital Experience With 96 Consecutive Cases 2009
- Role of laparoscopic treatment of endometriosis in patients with failed in vitro fertilization cycles 2005
- Urinary tract endometriosis treated by laparoscopy 1996
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