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01-10-2016 | General Gynecology

Impact of endometriosis on surgical outcomes and complications of total laparoscopic hysterectomy

Authors: Stefano Uccella, Nicola Marconi, Jvan Casarin, Marcello Ceccaroni, Luigi Boni, Davide Sturla, Maurizio Serati, Simona Carollo, Carolina Podesta’ Alluvion, Fabio Ghezzi

Published in: Archives of Gynecology and Obstetrics | Issue 4/2016

Abstract

Purpose

Total laparoscopic hysterectomy (TLH) in the case of endometriosis may be extremely challenging. Our aim has been to analyze perioperative details and complications of TLH in women with vs. women without endometriosis.

Methods

Consecutive women who underwent TLH for endometriosis (endometriosis group) were compared with consecutive patients who had TLH for other conditions (controls) in terms of perioperative outcomes. Patients in the endometriosis group were analyzed, according to the severity of the disease.

Results

One-hundred and twelve women in the endometriosis group, 29 (25.9 %) with minimal–mild, and 83 (74.1 %) with moderate–severe stage disease (rAFS score), respectively, were compared with 572 controls. Conversion rate was 0.8 vs. 0.5 % (P = 0.51), and median operative time was 75 vs. 55 min (pxxx = x) in the endometriosis group vs. controls. Intraoperative complications were similar between groups (P = 0.56). Postoperative complications occurred in 10 (12.3 %) women in the endometriosis group vs. 12 (3.3 %) among the controls (P = 0.002). The severity of complications according to Clavien–Dindo classification system was higher in the endometriosis group (Clavien–Dindo >2: 7.5 vs. 1.9 %). The risk of organ lesions, urinary lesions, postoperative complications, and severe adverse events was significantly higher in women with moderate–severe endometriosis vs. controls. No differences between patients with minimal–mild endometriosis and controls were found.

Conclusion(s)

TLH in the case of endometriosis is associated with longer operative time and an almost fourfold increase in the risk and severity of complications compared with controls. In particular, the adjunctive risk of adverse events is specific for moderate/severe-stage disease but not for minimal/mild endometriosis.

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Title: Impact of endometriosis on surgical outcomes and complications of total laparoscopic hysterectomy
Authors: Stefano Uccella
Nicola Marconi
Jvan Casarin
Marcello Ceccaroni
Luigi Boni
Davide Sturla
Maurizio Serati
Simona Carollo
Carolina Podesta’ Alluvion
Fabio Ghezzi
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 4/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4115-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of endometriosis on surgical outcomes and complications of total laparoscopic hysterectomy

Abstract

Purpose

Methods

Results

Conclusion(s)

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion(s)

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