Laparoscopic surgery in diagnosis and treatment of endometriosis

Objective & Hypothesis:OBJECTIVE: To analyse the clinical experience of a university hospital in laparoscopic (US) surgery regarding the diagnosis and management of endometriosis SETTING: Kocaeli University, School of Medicine, De¬partment of Obstetrics and Gynecology MATERIAL AND METHODS: Fifty four patients of endometriosis treated with laparoscopic interventions bet¬ween January 1997-January 2004 were analysed retrospectively.

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Key Findings & Data:RESULTS: Of 496 patients that had US surgery in this period, 54 cases (10.88%) were diagnosed and treated as endometriosis.

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Conclusion & Impact:Complications will further he reduced with increasing clinical experience of gynecologic surgeons.

🔬Design:Research Article

📍Scope:2004 Verileri

⚙️Variables:Ultrasonografi · Geriyedönük çalışma · Endometriyoz

Abstract

OBJECTIVE: To analyse the clinical experience of a university hospital in laparoscopic (US) surgery regarding the diagnosis and management of endometriosis SETTING: Kocaeli University, School of Medicine, De¬partment of Obstetrics and Gynecology MATERIAL AND METHODS: Fifty four patients of endometriosis treated with laparoscopic interventions bet¬ween January 1997-January 2004 were analysed retrospectively. RESULTS: Of 496 patients that had US surgery in this period, 54 cases (10.88%) were diagnosed and treated as endometriosis. The mean age of the patients was 31.5 (20-42). Thirty cases (55.5%) were complaining of primary in¬fertility while secondary infertility was determined in 5 pa¬tients (9.26%). Preoperative gynecologic and ultrasonog¬raphic evaluation demonstrated ovarian endometriomas in 42 patients (77.77%) of which 9 cases (21.42%) had bilate¬ral endometriomas. In 11 cases (20.37%) diagnostic US was planned. In 12 patients (22.22%) US endometrioma ex¬tirpation was performed. In 14 patients (25.92%) endomet¬rioma extirpation, cauterization of endometriotic implants and adhesiolysis , in 9 patients (16.16%) cauterization of endometriotic implants, in 8 patients (14.81%) endometrioma extirpation and cauterization of endometriotic imp¬lants, in 3 patients (5.55%) endometrioma extirpation and bilateral tubal ligation, in 2 patients (3.70%) adhesiolysis and cauterization of endometriotic implants, in 2 cases myolysis and cauterization of endometriotic implants were performed. Endometriosis lesions were classified as Stage I in 8 cases (14.81%), Stage II in 16 patients (29.62%), Stage III in 25 cases (46.29%), Stage IV in the remaining 5 pati¬ents (9.25%) according to revised American Fertilty Society classification. CONCLUSION: In spite of lacking complete unders¬tanding of the pathophysiology, evaluation and management of endometriosis, L/S still appears to be a safe and effective option in diagnosis and treatment. Complications will further he reduced with increasing clinical experience of gynecologic surgeons.

Özet

Amaç: Endometriozisin tanı ve tedavisinde bir üniversite kliniğinin laparoskopik (L/S) cerrahi deneyimlerini sunmak. Çalışmanın Yapıldığı Yer: Kocaeli Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı Materyal ve Metod: Ocak 1997-Ocak 2004 tarihleri arasında endometriozis öntanısı ile laparoskopik girişim uyguladığımız 54 olgu retrospektif olarak analiz edildi. Bulgular: Belirtilen zamanda laparoskopik cerrahi uygulanan toplam 496 olgunun 54’ü (%10.88) endometriozis nedeniyle girişim yapılan hastalardı. Olguların ortalama yaşı 31.5 (20-42) idi. Olgulardan 30’u (%55.5) primer infertilite, 5’i (%9.26) sekonder infertilite idi. Preoperatif jinekolojik ve ultrasonografik incelemeyle 42 olguda (%77.77) endometrioma saptandı, bu olguların 9’unda (%21.42) bilateral endometrioma vardı. On bir olguda (%20.37) diagnostik laparoskopi planlandı. On iki olguda (%22.22) L/S endometrioma ekstirpasyonu uygulandı. On dört olguda (%25.92) L/S endometrioma ekstirpasyonu, endometriotik implantların koterizasyonu ve adheziolizis, 9 hastada (%16.16) endometriotik implantların koterizasyonu, 8 olguda (%14.81) L/S endometrioma ekstirpasyonu, endometriotik implantların koterizasyonu, 3 olguda (%5.55) endometrioma ekstirpasyonu ve bilateral tubal ligasyon, 2 hastada (%3.70) adheziolizis ve endometriotik implantların koterizasyonu, 2 olguda ise myolizis ve endometriotic implantların koterizasyonu uygulandı. Endometriozis lezyonları, Amerikan Fertilite Derneği’nin sınIıflamasına göre 8 olguda (%14.81) Evre I, 16 olguda (%29.62) Evre II, 25 olguda (%46.29) Evre III, diğer 5 hastada (%9.25) Evre IV olarak değerlendirildi. Sonuçlar:Endometriozisin patofizyolojisi, olguların klinik değerlendirilmesi ve yönetimine dair yanıtlanmamış pek çok soru ve belirsizliklerin varlığına karşın laparoskopi, tanı ve tedavide halen en etkin ve emniyetli alternatif yaklaşımdır. Jinekologların laparoskopik cerrahide klinik deneyimlerinin giderek artması da komplikasyonların önemli ölçüde azalmasını sağlayacaktIır.

Keywords

Ultrasonografi Geriyedönük çalışma Endometriyoz Laparoskopi Ultrasonography Retrospective Studies Endometriosis Laparoscopy

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Cite This Article

VURAL, B., ÖZKAN, S., COŞKUN, E., YÜCESOY, G., ÇALIŞKAN, E., YÜCESOY, İ. (2005). Laparoscopic surgery in diagnosis and treatment of endometriosis. Türk Fertilite Dergisi, Cilt: 13 - Sayı: 2, 151–157. https://ajindex.com/articles/409089

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