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Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable. | LitMetric

AI Article Synopsis

  • The study investigates how pelvic endometriosis affects surgical outcomes in laparoscopic hysterectomy (LH), focusing on whether it should be considered an important factor in surgical evaluations.
  • Out of 2,655 LH cases analyzed, 15% had endometriosis, with stages I and II showing no significant effect on blood loss or operation time, while stages III and IV resulted in increased blood loss and longer surgeries.
  • The research suggests that only advanced stages (III and IV) of endometriosis impact LH outcomes significantly and should be included as case-mix variables in future assessments of surgical quality.

Article Abstract

Background: Pelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis influences surgical outcomes of LH and to determine if it should be considered as case-mix variable.

Results: A total of 2655 LH's were analyzed, of which 397 (15.0%) with concomitant endometriosis. For blood loss and operative time, no measurable association was found for stages I ( = 106) and II ( = 103) endometriosis compared to LH without endometriosis. LH with stages III ( = 93) and IV ( = 95) endometriosis were associated with more intra-operative blood loss ( = < .001) and a prolonged operative time ( = < .001) compared to LH without endometriosis. No significant association was found between endometriosis (all stages) and complications ( = .62).

Conclusions: The findings of our study have provided numeric support for the influence of concomitant endometriosis on surgical outcomes of LH, without bowel or bladder dissection. Only stages III and IV were associated with a longer operative time and more blood loss and should thus be considered as case-mix variables in future quality measurement tools.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856860PMC
http://dx.doi.org/10.1186/s10397-018-1039-3DOI Listing

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