Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection

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

Sandberg, E.M. (Leiden University Medical Center)
Driessen, S.R.C. (Leiden University Medical Center)
Bak, E.A.T. (Leiden University Medical Center)
van Geloven, N. (Leiden University Medical Center)
Berger, J.P. (Leiden University Medical Center; Haaglanden Medical Center)
Smeets, M.J.G.H. (Haaglanden Medical Center)
Rhemrev, J.P.T. (Haaglanden Medical Center)
Jansen, F.W. (TU Delft Medical Instruments & Bio-Inspired Technology; Leiden University Medical Center)

2018

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 (n = 106) and II (n = 103) endometriosis compared to LH without endometriosis. LH with stages III (n = 93) and IV (n = 95) endometriosis were associated with more intra-operative blood loss (p = <.001) and a prolonged operative time (p = <.001) compared to LH without endometriosis. No significant association was found between endometriosis (all stages) and complications (p =.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.

Case-mix correction
Concomitant endometriosis
Laparoscopic hysterectomy
Surgical outcome measures

http://resolver.tudelft.nl/uuid:c458fba4-1b1a-461f-91b3-15182aa323d3

https://doi.org/10.1186/s10397-018-1039-3

1613-2076

Gynecological Surgery, 15 (1)

Institutional Repository

journal article

© 2018 E.M. Sandberg, S.R.C. Driessen, E.A.T. Bak, N. van Geloven, J.P. Berger, M.J.G.H. Smeets, J.P.T. Rhemrev, F.W. Jansen