Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible?
Abstract
Background Little is known about the morbidity associated with laparoscopic complete excision of endometriosis in terms of urinary, digestive and sexual function. Methods We performed a prospective non-randomized study in 45 patients with laparoscopic complete excision of all detectable foci of endometriosis with segmental bowel resection using a non nerve-sparing technique (control group-group A n=20) and a nerve-sparing technique (case group-group B n=25). At initial gynaecological evaluation, and at follow-up details on dysmenorrhoea, pelvic pain, dyspareunia and dyschezia were evaluated using an interview-based questionnaire (10-point analogue rating scale: 0=absent, 10=unbearable). Results The mean (+/-SD) follow-up period was 15.3+/-10 months (range, 8.8-23 months) for group A and 3.5+/-2.1 months (range, 0.3-5.2 months) for group B. In the immediate postoperative course, in group A three women required blood transfusion vs seven women in group B (P=0.003). The median time to resume the voiding function was significantly shorter in group B (12.5 vs 3.0 days; P Conclusions Laparoscopic nerve-sparing complete excision of endometriosis seems to be feasible and offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique. Larger series with longer follow-up are needed to confirm our results.
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At the authors' institution, in the last 7 years, 789 laparoscopic bowel resections for 307 severe endometrioses have been performed.
“At our institution, in the last 7 years, 789 laparoscopic bowel resections for 307 severe endometrioses have been performed [47, 25–27, 45–48].”
Endometriosis has an "onco-mimetic nature", which reflects in many aspects the clinico pathological features of ovarian cancer.
“As can be easily shown in this case and in our series, endometriosis has in fact an “onco-mimetic nature”, which reflects in many aspects the clinico pathological features of ovarian cancer [25–27, 45–48].”
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- Authors
- Landi, S., Ceccaroni, M., Perutelli, A., Allodi, C., Barbieri, F., Fiaccavento, A., Ruffo, G., McVeigh, E., Zanolla, L., & Minelli, L.
- Affiliations
- Ospedale Sacro Cuore Don Calabria (IT)
- Corresponding author
- Landi, S.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-01-31
- Volume
- 21
- Issue
- 3
- Pages
- 774-781
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2102284561
- Cited by
- 149
- References
- 1
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 2 · 2018: 7 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 8 · 2013: 10 · 2012: 11
- FWCI
- 10.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- deep infiltrating endometriosis, laparoscopic resection, nerve-sparing technique, segmental bowel resection, postoperative urinary dysfunction, blood transfusion, dyspareunia, dyschezia, patient satisfaction, pelvic pain, dysmenorrhea
- MeSH terms
- Adult, Endometriosis, Endometrium, Feasibility Studies, Female, Humans, Postoperative Pain, Laparoscopy, Surveys and Questionnaires, Reoperation, Splanchnic Nerves, Treatment Outcome
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