Casarin, Jvan; Ghezzi, Fabio; Mueller, Michael; Ceccaroni, Marcello; Papadia, Andrea; Ferreira, Helder; Uccella, Stefano; Malzoni, Mario; Mabrouk, Mohamed; Seracchioli, Renato; Bordi, Giulia; Gisone, Baldo Emanuele; Vaineau, Cloé; Bogani, Giorgio; Roviglione, Giovanni; Arena, Alessandro; Ambrosoli, Andrea Luigi; Graf, Carla; Bruni, Francesco; Bras, Rafael; ... (2023). Surgical Outcomes and Complications of Laparoscopic Hysterectomy for Endometriosis: a multicentric cohort study. Journal of minimally invasive gynecology, 30(7), pp. 587-592. Elsevier 10.1016/j.jmig.2023.03.018
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STUDY OBJECTIVE
To investigate the postoperative morbidity of laparoscopic hysterectomy (LH) for endometriosis/adenomyosis in terms of operative outcomes and complications.
DESIGN
Retrospective multicentric cohort study.
SETTING
Eight European minimally invasive referral centers.
PATIENTS
Data from 995 patients with pathologically confirmed endometriosis and/or adenomyosis who underwent LH without concomitant urological and/or gastroenterological procedures from January 2010 to December 2020.
INTERVENTIONS
Total laparoscopic hysterectomy.
MEASUREMENTS AND MAIN RESULTS
Demographic patients' characteristics, surgical outcomes, and intraoperative and postoperative complications were evaluated. We considered major postoperative surgical-related complications any grade 2 or more events (Clavien-Dindo score) that occurred within 30 days from surgery. Univariate analysis and multivariable models fit with logistic regression were used to estimate the adjusted odds ratio (OR) and corresponding 95% CI for major complications. Median age at surgery was 44 years (28-54) and about half of them (505, 50.7%) were on medical treatment (estro-progestins, progestin or GnRh-analogues) at the time of surgery. In association with LH, posterior adhesiolysis was performed in 387 (38,9%) cases and deep nodule resection in 302 (30,0%). Intraoperative complications occurred in 3% of the patients and major postoperative complications were registered in 93 (9.3%). The multivariable analysis showed an inverse correlation between the occurrence of Clavien-Dindo >2 complications and age (OR 0.94, 95%CI 0.90-0.99), while previous surgery for endometriosis (OR 1.62, 95%CI 1.01-2.60) and intraoperative complications (OR 6.49, 95%CI 2.65-16.87) were found as predictors of major events. Medical treatment at the time of surgery has emerged as a protective factor (OR 0.50, 95%CI 0.31-0.81).
CONCLUSION
LH for endometriosis/adenomyosis is associated with non-negligible morbidity. Knowing the factors associated with higher risks of complications might be used for risk stratification and could help clinicians during preoperative counseling. The administration of estro-progestin or progesterone preoperatively might reduce the risks of postoperative complications following surgery.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology |
UniBE Contributor: |
Mueller, Michael, Vaineau-Bemilli, Cloé Juliette |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1553-4650 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
03 Apr 2023 16:55 |
Last Modified: |
01 Apr 2024 00:25 |
Publisher DOI: |
10.1016/j.jmig.2023.03.018 |
PubMed ID: |
37004810 |
Uncontrolled Keywords: |
Hysterectomy adenomyosis complications endometriosis laparoscopic surgery morbidity |
BORIS DOI: |
10.48350/181396 |
URI: |
https://boris.unibe.ch/id/eprint/181396 |
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