Improvement in quality of life and pain scores after laparoscopic management of deep endometriosis: a retrospective cohort study.


Bastu E., Celik H., Kocyigit Y., Yozgatli D., Yasa C., Ozaltin S., ...Daha Fazla

Archives of gynecology and obstetrics, cilt.302, sa.1, ss.165-172, 2020 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 302 Sayı: 1
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1007/s00404-020-05583-6
  • Dergi Adı: Archives of gynecology and obstetrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.165-172
  • Anahtar Kelimeler: Endometriosis, Deep endometriosis, Pelvic pain, BSGE pelvic pain questionnaire, Surgical treatment of endometriosis, INFILTRATING ENDOMETRIOSIS, BOWEL RESECTION, CONSERVATIVE SURGERY, COLORECTAL RESECTION, EXCISION, THERAPY, DISEASE
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Purpose This is a retrospective cohort study that evaluates the postoperative pain findings of a consecutive series of laparoscopic surgeries for deep endometriosis (DE). Methods This multi-center retrospective cohort study was carried out in university hospitals (Istanbul, Turkey). Sixty-five patients diagnosed through bimanual gynecologic examination, gynecologic ultrasound or magnetic resonance imaging-confirmed endometrioma and DE together; who underwent a laparoscopic surgery between 2013 and 2019 by a team of gynecologists, colorectal surgeons, and a urologist were retrospectively evaluated. The data were collected in a specific database and analyzed for postoperative pain outcomes through a comparison with preoperative symptoms scored using a visual analogue score (VAS), and the British Society of Gynecologic Endoscopy (BSGE) pelvic pain questionnaire. Results Sixty-five patients who met the criteria were included. The mean age of all patients was 35.0 +/- 6.3 (range 22-50) years. The mean operative time was 121.3 +/- 50.2 (range, 60-270) minutes. Preoperative and postoperative comparison of VAS scores for dysmenorrhea (8.57 vs. 2.91), dyspareunia (6.62 vs. 1.66), dyschezia (7.46 vs. 2.43), dysuria (5.67 vs. 1.34), chronic pelvic pain (4.11 vs. 1.22), and BSGE score (40.98 vs. 11.00) showed significantly reduced pain scores, respectively (p < 0.01). Conclusion Laparoscopic management of DE is a valid treatment option in terms of reduced postoperative pain and increased quality of life according to pain score outcomes. To have more robust conclusions, a prospective cohort study with a larger sample size which evaluates patients who had segmental bowel resection and those who did not have segmental bowel resection is necessary.