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Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement

STUDY OBJECTIVE: To describe complications following surgery for deep endometriosis (DE) without bowel involvement and to develop a nomogram for predicting postoperative complications. DESIGN: Retrospective study SETTING: Tertiary referral university hospital and expert center in endometriosis PATIE...

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Autores principales: Poupon, Clothilde, Owen, Clémentine, Arfi, Alexandra, Cohen, Jonathan, Bendifallah, Sofiane, Daraï, Emile
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687381/
https://www.ncbi.nlm.nih.gov/pubmed/31403118
http://dx.doi.org/10.1016/j.eurox.2019.100028
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author Poupon, Clothilde
Owen, Clémentine
Arfi, Alexandra
Cohen, Jonathan
Bendifallah, Sofiane
Daraï, Emile
author_facet Poupon, Clothilde
Owen, Clémentine
Arfi, Alexandra
Cohen, Jonathan
Bendifallah, Sofiane
Daraï, Emile
author_sort Poupon, Clothilde
collection PubMed
description STUDY OBJECTIVE: To describe complications following surgery for deep endometriosis (DE) without bowel involvement and to develop a nomogram for predicting postoperative complications. DESIGN: Retrospective study SETTING: Tertiary referral university hospital and expert center in endometriosis PATIENTS: Two-hundred and twenty patients with DE without bowel involvement INTERVENTIONS: Laparoscopic resection for DE without bowel involvement MEASUREMENTS AND MAIN RESULTS: Operative complications were evaluated using the Clavien-Dindo classification. Voiding dysfunction was defined as a need for bladder self-catheterization lasting >1 month. Fifty-three patients (24%) had postoperative complications: 31 (14%) had a Clavien-Dindo grade I—II complication (3 grade I and 28 grade II); 11 (5%) had a grade III complication (2 grade IIIa and 9 grade IIIb); and 11 (5%) had voiding dysfunction. No grade IV—V complications were observed. Age, Enzian classification risk group, and previous surgery for endometriosis were significantly associated with postoperative complications. The predictive model had an AUC of 0.72 (95% CI, 0.70–0.74) before and 0.70 (95% CI, 0.68–72) after bootstrap sample correction. The average difference and maximal difference in predicted and calibrated probabilities of recurrence were 0.023 and 0.089% respectively CONCLUSION: Surgery for DE without bowel resection is associated with a relatively high incidence of voiding dysfunction and postoperative complications mainly corresponding to Clavien-Dindo grade I—II. Age, risk group of Enzian classification, and previous surgery for endometriosis are significantly associated with postoperative complications and voiding dysfunction. Our results allowed us to build a nomogram which can be used to better inform patients about the risk of DE surgery without bowel involvement
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spelling pubmed-66873812019-08-09 Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement Poupon, Clothilde Owen, Clémentine Arfi, Alexandra Cohen, Jonathan Bendifallah, Sofiane Daraï, Emile Eur J Obstet Gynecol Reprod Biol X Gynaecology STUDY OBJECTIVE: To describe complications following surgery for deep endometriosis (DE) without bowel involvement and to develop a nomogram for predicting postoperative complications. DESIGN: Retrospective study SETTING: Tertiary referral university hospital and expert center in endometriosis PATIENTS: Two-hundred and twenty patients with DE without bowel involvement INTERVENTIONS: Laparoscopic resection for DE without bowel involvement MEASUREMENTS AND MAIN RESULTS: Operative complications were evaluated using the Clavien-Dindo classification. Voiding dysfunction was defined as a need for bladder self-catheterization lasting >1 month. Fifty-three patients (24%) had postoperative complications: 31 (14%) had a Clavien-Dindo grade I—II complication (3 grade I and 28 grade II); 11 (5%) had a grade III complication (2 grade IIIa and 9 grade IIIb); and 11 (5%) had voiding dysfunction. No grade IV—V complications were observed. Age, Enzian classification risk group, and previous surgery for endometriosis were significantly associated with postoperative complications. The predictive model had an AUC of 0.72 (95% CI, 0.70–0.74) before and 0.70 (95% CI, 0.68–72) after bootstrap sample correction. The average difference and maximal difference in predicted and calibrated probabilities of recurrence were 0.023 and 0.089% respectively CONCLUSION: Surgery for DE without bowel resection is associated with a relatively high incidence of voiding dysfunction and postoperative complications mainly corresponding to Clavien-Dindo grade I—II. Age, risk group of Enzian classification, and previous surgery for endometriosis are significantly associated with postoperative complications and voiding dysfunction. Our results allowed us to build a nomogram which can be used to better inform patients about the risk of DE surgery without bowel involvement Elsevier 2019-05-02 /pmc/articles/PMC6687381/ /pubmed/31403118 http://dx.doi.org/10.1016/j.eurox.2019.100028 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Gynaecology
Poupon, Clothilde
Owen, Clémentine
Arfi, Alexandra
Cohen, Jonathan
Bendifallah, Sofiane
Daraï, Emile
Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title_full Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title_fullStr Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title_full_unstemmed Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title_short Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
title_sort nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement
topic Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687381/
https://www.ncbi.nlm.nih.gov/pubmed/31403118
http://dx.doi.org/10.1016/j.eurox.2019.100028
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