Surgical outcomes of laparoscopic endometriosis surgery: a 6 year experience

Abstract

Objectives: The aim of the present study was to review 6 year experience on the surgical outcomes of laparoscopic endometriosis surgery.

Methods: A cohort study was performed in Shiraz University of Medical Sciences using data from medical records of 1315 cases of patients with endometriosis undergoing laparoscopic surgery with follow-up of 6 to 72 months.

Results: This study concerned a cohort of 1315 patients diagnosed with endometriosis operated between April 2010 and April 2016, 1086 (82.5%) of whom were in stage III and IV; 968 (73.61%) had endometrioma (regardless of having deep infiltrative endometriosis [DIE] or peritoneal involvement) and 347 (26.39%) of patients had either DIE or peritoneal involvement without endometrioma. Regarding the patients, unilateral endometrioma was statistically significant in the left ovary (p = .002). One hundred and thirty-three (10.7%) rectal wall, 7 (0.32%) sigmoid colon, 4 (0.18%) vagina, 125 (5.6%) ureter and 33 (1.52) bladder involvements were detected. Prior to operation, the pain VAS score was 8.23 ± 2.03, which decreased to 4.46 ± 2.47 in 93.07% of patients. Fifty-three patients (6.56%) needed reoperation. Sixty-six (33.1%) infertile women had spontaneous pregnancy and 15 (25%) became pregnant using intrauterine insemination (IUI) or assisted reproductive technique (ART) post-operatively.

Conclusion: Surgical treatment of endometriosis seems to be an effective treatment. DIE can be present in the absence of endometrioma. The rate of left endometrioma is higher due to the pressure effect of the sigmoid colon. Nonetheless, if an expert surgeon performs this procedure, not only the rate of post-operative complications, but also the possibility of recurrence would decrease.

Keywords:

• Dysmenorrhea
• endometriosis
• surgical outcome
• DIE

Transparency

Declaration of funding

This paper received no sponsorship/funding.

Author contributions: S.A.: conception and design, surgeon; A.H.N.: conception and design, analysis and interpretation of the data, drafting and revision; T.P.: data collection, data analysis, drafting and revision; Z.S.: data collection, data analysis, drafting and revision. All authors agree to be accountable for all aspects of the work.

Declaration of financial/other relationships

S.A., A.H.N., T.P. and Z.S. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to acknowledge all the patients and their families who patiently participated in the study and followed it to the end. We also thank the laparoscopy research center, Shiraz University of Medical Sciences, Iran.