Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable.
Evelien M Sandberg, Sara R C Driessen, Evelien A T Bak, Nan van Geloven, Judith P Berger, Mathilde J G H Smeets, Johann P T Rhemrev, Frank Willem Jansen
{"title":"Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable.","authors":"Evelien M Sandberg, Sara R C Driessen, Evelien A T Bak, Nan van Geloven, Judith P Berger, Mathilde J G H Smeets, Johann P T Rhemrev, Frank Willem Jansen","doi":"10.1186/s10397-018-1039-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Results: </strong>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 (<i>n</i> = 106) and II (<i>n</i> = 103) endometriosis compared to LH without endometriosis. LH with stages III (<i>n</i> = 93) and IV (<i>n</i> = 95) endometriosis were associated with more intra-operative blood loss (<i>p</i> = < .001) and a prolonged operative time (<i>p</i> = < .001) compared to LH without endometriosis. No significant association was found between endometriosis (all stages) and complications (<i>p</i> = .62).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-018-1039-3","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gynecological Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s10397-018-1039-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/3/16 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
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 (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.
期刊介绍：
"Gynecological Surgery", founded in 2004, is the first and premier peer-reviewed scientific journal dedicated to all aspects of research, development, and training in gynecological surgery. This field is rapidly changing in response to new developments and innovations in endoscopy, robotics, imaging and other interventional procedures. Gynecological surgery is also expanding and now encompasses all surgical interventions pertaining to women health, including oncology, urogynecology and fetal surgery. The Journal publishes Original Research, Reviews, Evidence-based Viewpoints on clinical protocols and procedures, Editorials, Perspectives, Communications and Case Reports.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
