Laparoscopic surgical treatment of pelvic endometriosis. Experience of a Portuguese University Hospital

  • Brás R
  • Ferreira H
  • Braga A
  • et al.
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Abstract

Background Pelvic Endometriosis is a common condition associated with disabling symptoms with great impact on the quality of life. The objective of this study is to analyze our experience in the surgical treatment of pelvic endometriosis. Methods A descriptive retrospective study including all surgical treatments in patients with pelvic endometriosis between January 2012 and December 2014 in a Portuguese university hospital. Parameters registered: surgical indication, laparoscopic evaluation of the disease location, the type of surgical treatment, the operative complications, the need for conversion to laparotomy, duration of hospitalization, duration of surgery, postoperative sequelae and the impact on the quality of life after surgery Results We included 123 cases, with a mean age of 36.2 years. The most frequent indication was disabling cyclic dyspareunia and pelvic pain (92% of cases) followed by the presence of endometrioma (84% of cases). The most common surgical procedures were adhesiolysis (93% of cases) and the excision of ovarian endometriomas (82% of cases). Nodule excision of the rectovaginal septum was performed in 28% of cases, rectal shaving 24%, discoid bowel resection in 13% and segment bowel resection in 3% of cases. It was also performed partial cystectomy in 3% of surgeries and ureteroneocystostomy in 1 patient. The mean duration of surgery was 82 minutes. The average hospital stay was 3.1 days. It has been found that there are intra or postoperative complications in 3.7% of cases. There was a need for conversion to laparotomy in 2 cases. We found clinical improvement in 92% of patients. Conclusions The laparoscopic approach is the gold standard of surgical treatment of pelvic endometriosis. Our short experience has shown good results, with improvement of the patients quality of life, associated with a low rate of complications.

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Brás, R., Ferreira, H., Braga, A., Morgado, A., & Pereira, A. T. (2016). Laparoscopic surgical treatment of pelvic endometriosis. Experience of a Portuguese University Hospital. European Journal of Obstetrics & Gynecology and Reproductive Biology, 206, e21. https://doi.org/10.1016/j.ejogrb.2016.07.080

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