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

A cohort analysis to define a case-mix variable

Journal article (2018)

Authors

Evelien M. Sandberg Leiden University Medical Center
Sara R C Driessen Leiden University Medical Center
Evelien A.T. Bak Leiden University Medical Center
Nan van Geloven Leiden University Medical Center
Judith P. Berger Haaglanden Medical Center, Leiden University Medical Center
Mathilde J.G.H. Smeets Haaglanden Medical Center
Johann P T Rhemrev Haaglanden Medical Center
F.W. Jansen Medical Instruments & Bio-Inspired Technology - Mechanical, Maritime and Materials Engineering , Leiden University Medical Center
Research Group
Medical Instruments & Bio-Inspired Technology (Mechanical, Maritime and Materials Engineering) (TU Delft)
Copyright: © 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
DOI: https://doi.org/10.1186/s10397-018-1039-3
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Published Date

2018

Language

English

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Faculty

Mechanical, Maritime and Materials Engineering

Department

Biomechanical Engineering

Research Group

Medical Instruments & Bio-Inspired Technology

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.

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