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Fertil Steril. 2010 Jan;93(1):39-45. doi: 10.1016/j.fertnstert.2008.09.051. Epub 2008 Oct 29.

Short-term outcome of fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis performed in a tertiary referral center.

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1
Institute of Women's Health, University College London Hospitals, London, United Kingdom.

Abstract

OBJECTIVE:

To examine the short-term surgical outcomes in women undergoing fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis.

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary referral center for treatment of endometriosis, a university teaching hospital, London, United Kingdom.

PATIENT(S):

A total of 177 women who underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis between January 1, 2006, and December 31, 2007.

INTERVENTION(S):

Eligible women were identified from the surgeons' database, and their medical notes were reviewed. Data from preoperative assessment, surgery, and postoperative outcomes were analyzed.

MAIN OUTCOME MEASURE(S):

Complication rate.

RESULT(S):

One hundred seventy-seven women underwent fertility-sparing laparoscopic excision of deeply infiltrating endometriosis including excision of uterosacral ligaments (43, 24.3%), excision of rectovaginal septum (56, 31.6%), rectal shave (56, 31.6%), disk excision (7, 4%) or bowel resection (15, 8.5%). The median operative time was 95 minutes with a range of 30 to 270 minutes (interquartile range 75-120 minutes). Overall, complications developed in 18 women (10.2%). In 12 (6.8%) of these only uncomplicated pyrexia developed whereas significant intraoperative and/or postoperative complications developed in the remaining 6 (3.4%). Women spent a median of 2 days recovering in hospital (range 1-7, interquartile range 2-3 days).

CONCLUSION(S):

Fertility-sparing laparoscopic excision of deeply infiltrating endometriosis appears to be safe with a low short-term complication rate.

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