Laparoscopic Modified Radical Hysterectomy for Severe Endometriosis: A Single-Center Case Series.
J Minim Invasive Gynecol
; 31(5): 423-431, 2024 May.
Article
in En
| MEDLINE
| ID: mdl-38325580
ABSTRACT
STUDY OBJECTIVE:
The main objective is to describe the feasibility and report a single-center experience of a standardized laparoscopic modified radical hysterectomy technique among patients with severe endometriosis and pouch of Douglas obliteration.DESIGN:
A single-center case series of laparoscopic modified radical hysterectomy performed at the Poissy Hospital between December 2012 and May 2021. SETTINGS Single-center, gynecology unit (level III) with a focus on endometriosis. PATIENTS Patients with severe endometriosis (stage 4 American Fertility Society) and pouch of Douglas obliteration. MEASUREMENTS AND MAINRESULTS:
Fifty-two patients with severe endometriosis underwent the surgical procedure. Of these patients, 23.1% underwent a rectal shaving (n = 12), 1.9% a discoid resection (n = 1), and 17.3% a rectal resection (n = 9), including a protective ileostomy in 1 case. Ureterolysis was performed on 82.7% of patients (n = 43). The average hospital stay was 3.3 days. Seven patients required intermittent self-catheterization (13.5%). Minor complications (Clavien-Dindo grade 1 and 2) occurred in 25.9% of the patients and severe complications in 3.8% of them (Clavien-Dindo grade 3, no grade 4). Two patients (3.8%) were reoperated one for a postoperative occipital alopecia (balding) and the other for vaginal dehiscence with evisceration. Approximately 50 patients (96.2%) had a complete resection of endometriosis. The median follow-up was 14 months (interquartile range, 6-23 mo) with 94.3% of them improved (much and very much) and 3.8% minimally improved.CONCLUSION:
In our experience, laparoscopic modified radical hysterectomy is a reliable procedure with a low rate of severe complications. This technique needs to be assessed by other surgeons and others centers across the country and abroad, to determine the likelihood of it succeeding.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Laparoscopy
/
Endometriosis
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Hysterectomy
Limits:
Adult
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
J Minim Invasive Gynecol
Journal subject:
GINECOLOGIA
Year:
2024
Type:
Article