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Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible?
OBJECTIVE: Evaluate the type and incidence of postoperative complications after surgery for deep infiltrative endometriosis at Biocor Hospital. METHODS: Our observational study involved a multidisciplinary surgical team that performed laparoscopy on 154 patients suffering from pelvic pain. Surgical...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Brazilian Society of Assisted Reproduction
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239420/ https://www.ncbi.nlm.nih.gov/pubmed/35761742 http://dx.doi.org/10.5935/1518-0557.20140020 |
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author | de Ávila, Ivete Costa, Luciana M P Soto Jr., Mario Filogônio, Ivone D S Carneiro, Márcia M |
author_facet | de Ávila, Ivete Costa, Luciana M P Soto Jr., Mario Filogônio, Ivone D S Carneiro, Márcia M |
author_sort | de Ávila, Ivete |
collection | PubMed |
description | OBJECTIVE: Evaluate the type and incidence of postoperative complications after surgery for deep infiltrative endometriosis at Biocor Hospital. METHODS: Our observational study involved a multidisciplinary surgical team that performed laparoscopy on 154 patients suffering from pelvic pain. Surgical complications occurring up to the 30(th) postoperative day were recorded. RESULTS: Mean age patient age was 34.1 years. Infertility was present in 69 (45%) although 31% had not attempted to get pregnant. Dysmenorrhea was the most frequent symptom (79.3%) followed by chronic pelvic pain (59.7%) and deep dyspareunia (48,7%). Most cases required extensive surgery as the majority (n=117; 76.9%) were classified as severe endometriosis (ASRM grade IV). The most frequent surgical procedures were: 136 adhesiolysis, 100 intestinal surgeries (85 retosigmoidectomies), 92 peritonal lesion excision, 39 vaginal resections, 19 myomectomies, 21 hysterectomies and 5 partial bladder resections. Postoperative complications were recorded in 14 (9.59%) patients: 8 (5.48%) major complications and 6 (4.11%) minor. Major complications included blood transfusion (n=2) retosigmoid anastomosis dehiscence (1), rectovaginal fistula (n=1), urinary fistula (n=1), deep vein thrombosis (n=1), lower limb compartment syndrome with motor deficit (n=1) and one intestinal obstruction (n=1). Minor complications were abdominal wall infection (n=3), peripheral neuropathy (n=3), bladder atony (n=1) and bladder perforation (n=1). No deaths were observed. All major complication cases underwent retosigmoidectomy associated with vaginal resection (n=6), uterosacral ligament excision (n=5) or hysterectomy (n=3). CONCLUSION: The surgical treatment of DIE is complex and subject to complications. The surgical expertise of a multidisciplinary team plays a vital role in this setting. |
format | Online Article Text |
id | pubmed-9239420 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Brazilian Society of Assisted Reproduction |
record_format | MEDLINE/PubMed |
spelling | pubmed-92394202022-06-30 Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? de Ávila, Ivete Costa, Luciana M P Soto Jr., Mario Filogônio, Ivone D S Carneiro, Márcia M JBRA Assist Reprod Original Article OBJECTIVE: Evaluate the type and incidence of postoperative complications after surgery for deep infiltrative endometriosis at Biocor Hospital. METHODS: Our observational study involved a multidisciplinary surgical team that performed laparoscopy on 154 patients suffering from pelvic pain. Surgical complications occurring up to the 30(th) postoperative day were recorded. RESULTS: Mean age patient age was 34.1 years. Infertility was present in 69 (45%) although 31% had not attempted to get pregnant. Dysmenorrhea was the most frequent symptom (79.3%) followed by chronic pelvic pain (59.7%) and deep dyspareunia (48,7%). Most cases required extensive surgery as the majority (n=117; 76.9%) were classified as severe endometriosis (ASRM grade IV). The most frequent surgical procedures were: 136 adhesiolysis, 100 intestinal surgeries (85 retosigmoidectomies), 92 peritonal lesion excision, 39 vaginal resections, 19 myomectomies, 21 hysterectomies and 5 partial bladder resections. Postoperative complications were recorded in 14 (9.59%) patients: 8 (5.48%) major complications and 6 (4.11%) minor. Major complications included blood transfusion (n=2) retosigmoid anastomosis dehiscence (1), rectovaginal fistula (n=1), urinary fistula (n=1), deep vein thrombosis (n=1), lower limb compartment syndrome with motor deficit (n=1) and one intestinal obstruction (n=1). Minor complications were abdominal wall infection (n=3), peripheral neuropathy (n=3), bladder atony (n=1) and bladder perforation (n=1). No deaths were observed. All major complication cases underwent retosigmoidectomy associated with vaginal resection (n=6), uterosacral ligament excision (n=5) or hysterectomy (n=3). CONCLUSION: The surgical treatment of DIE is complex and subject to complications. The surgical expertise of a multidisciplinary team plays a vital role in this setting. Brazilian Society of Assisted Reproduction 2014 /pmc/articles/PMC9239420/ /pubmed/35761742 http://dx.doi.org/10.5935/1518-0557.20140020 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article de Ávila, Ivete Costa, Luciana M P Soto Jr., Mario Filogônio, Ivone D S Carneiro, Márcia M Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title | Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title_full | Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title_fullStr | Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title_full_unstemmed | Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title_short | Safe multidisciplinary approach in deeply infiltrating endometriosis (DIE): is it feasible? |
title_sort | safe multidisciplinary approach in deeply infiltrating endometriosis (die): is it feasible? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239420/ https://www.ncbi.nlm.nih.gov/pubmed/35761742 http://dx.doi.org/10.5935/1518-0557.20140020 |
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