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01-03-2020 | Laparotomy | General Gynecology

Extensive endometriosis surgery: rASRM and Enzian score independently relate to post-operative complication grade

Authors: Kristin Nicolaus, Stefan Zschauer, Dominik Bräuer, Jorge Jimenez-Cruz, Thomas Lehmann, Matthias Rengsberger, Herbert Diebolder, Ingo B. Runnebaum

Published in: Archives of Gynecology and Obstetrics | Issue 3/2020

Abstract

Purpose

We aimed to assess post-operative complications based on the Clavien–Dindo classification system following routine laparoscopic treatment of all stages of endometriosis.

Methods

A retrospective cohort study was carried out to identify women who underwent laparoscopic complete resection of newly diagnosed endometriosis between 2013 and 2016. 401 patients were identified using hospital database search software, and electronic files were reviewed. The stages of endometriosis had been classified according to the revised score of the American Society of Reproductive Medicine (rASRM) and the Enzian classification in cases of deep infiltrating endometriosis. Post-operative complications were recorded based on the Clavien–Dindo classification. Multivariate regression analysis was used to investigate the impact of the stages of endometriosis and surgical steps on complications.

Results

Grade III complications requiring surgical, endoscopic, or radiological intervention occurred in only 1.7% of patients and were significantly associated with rASRM stage IV (OR 1.8). Grade II complications (blood transfusion, total parenteral nutrition) occurred in 18.7% of patients. rASRM stage IV (OR 2.0), hysterectomy (OR 3.2), conversion to laparotomy (OR 11.1), and bowel resection (OR 27.6) were significantly associated with increased risk of grade II complications. rASRM stages I–III did not show an effect on post-operative complications or hospital stay.

Conclusions

Clavien–Dindo complication grading was readily applicable to laparoscopic removal of endometriosis of all stages. Higher Clavien–Dindo grades correctly reflected clinically relevant complications and were associated with deep infiltrating endometriosis, stage IV endometriosis, bowel surgery, or hysterectomy. Clavien–Dindo classification can be recommended for evaluation of laparoscopic endometriosis surgery outcome.

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Title: Extensive endometriosis surgery: rASRM and Enzian score independently relate to post-operative complication grade
Authors: Kristin Nicolaus
Stefan Zschauer
Dominik Bräuer
Jorge Jimenez-Cruz
Thomas Lehmann
Matthias Rengsberger
Herbert Diebolder
Ingo B. Runnebaum
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Laparotomy
Laparotomy
Endometriosis
Hysterectomy
Published in: Archives of Gynecology and Obstetrics / Issue 3/2020
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05425-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extensive endometriosis surgery: rASRM and Enzian score independently relate to post-operative complication grade

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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