Diego Raimondo1, Ivano Raimondo2,3, Eugenia Degli Esposti4, Giulia Mattioli1, Manuela Mastronardi1, Marco Petrillo2,3, Salvatore Dessole2,3, Mohamed Mabrouk1,5, Simona Del Forno1, Alessandro Arena1, Giulia Borghese1, Renato Seracchioli1. 1. Department of Obstetrics and Gynecology, DIMEC, S. Orsola Hospital, University of Bologna, Massarenti, 13, 40138, Bologna, Italy. 2. Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 3. School in Biomedical Sciences, University of Sassari, Sassari, Italy. 4. Department of Obstetrics and Gynecology, DIMEC, S. Orsola Hospital, University of Bologna, Massarenti, 13, 40138, Bologna, Italy. eugenia.degliesposti@gmail.com. 5. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Cambridge Clinical School, The Rosie Hospital, Robinson Way, Box 223, Cambridge, CB2 0SW, UK.
Abstract
PURPOSE: To evaluate the feasibility and safety of laparoscopic excision of endometriotic lesions in obese women. METHODS: Retrospective analysis of prospectively collected data involving consecutive women scheduled for complete laparoscopic removal of macroscopic endometriotic lesions between January 2012 and November 2018. Operative time, laparotomic conversion rates, complication rates, and length of hospital stay were recorded. RESULTS: One thousand two hundred thirty women were enrolled and divided into two main groups, according to the World Health Organization classification of obesity, obese (body mass index ≥ 30 kg/m2) and non-obese (body mass index < 30 kg/m2). During the study period, 91 (7.4% of overall study cohort) obese women underwent surgery. At univariate analyses, significant differences between the two groups were found in terms of age, rates of severe endometriosis, American Society of Anesthesiologists physical status classification ≥ III, and different surgical procedures. Significant differences in terms of median operative time [125 (interquartile range (IQR) 85-165) in obese group vs 110 min (IQR 75-155) in non-obese group, P = 0.04] were observed. There were no significant differences between the obese and non-obese groups with respect to the other variables of interest. After adjusted multivariable regression models for potential confounders, difference in operating time (coefficient of 13.389; 95% CI 1.716, 25.060) was still found to be significant. CONCLUSION: In our tertiary care referral center, laparoscopic removal of endometriosis is feasible and safe, except for a slight increase of operative time and conversion rate.
PURPOSE: To evaluate the feasibility and safety of laparoscopic excision of endometriotic lesions in obesewomen. METHODS: Retrospective analysis of prospectively collected data involving consecutive women scheduled for complete laparoscopic removal of macroscopic endometriotic lesions between January 2012 and November 2018. Operative time, laparotomic conversion rates, complication rates, and length of hospital stay were recorded. RESULTS: One thousand two hundred thirty women were enrolled and divided into two main groups, according to the World Health Organization classification of obesity, obese (body mass index ≥ 30 kg/m2) and non-obese (body mass index < 30 kg/m2). During the study period, 91 (7.4% of overall study cohort) obesewomen underwent surgery. At univariate analyses, significant differences between the two groups were found in terms of age, rates of severe endometriosis, American Society of Anesthesiologists physical status classification ≥ III, and different surgical procedures. Significant differences in terms of median operative time [125 (interquartile range (IQR) 85-165) in obese group vs 110 min (IQR 75-155) in non-obese group, P = 0.04] were observed. There were no significant differences between the obese and non-obese groups with respect to the other variables of interest. After adjusted multivariable regression models for potential confounders, difference in operating time (coefficient of 13.389; 95% CI 1.716, 25.060) was still found to be significant. CONCLUSION: In our tertiary care referral center, laparoscopic removal of endometriosis is feasible and safe, except for a slight increase of operative time and conversion rate.
Authors: Allison F Vitonis; Heather J Baer; Susan E Hankinson; Marc R Laufer; Stacey A Missmer Journal: Hum Reprod Date: 2010-02-19 Impact factor: 6.918
Authors: Melissa E Heard; Stepan B Melnyk; Frank A Simmen; Yanqing Yang; John Mark P Pabona; Rosalia C M Simmen Journal: Endocrinology Date: 2016-05-13 Impact factor: 4.736