TY - JOUR
T1 - Tailoring radicality in demolitive surgery for deeply infiltrating endometriosis
AU - Fedele, Luigi
AU - Bianchi, Stefano
AU - Zanconato, Giovanni
AU - Berlanda, Nicola
AU - Borruto, Franco
AU - Frontino, Giada
PY - 2005/7
Y1 - 2005/7
N2 - Objective: The purpose of this study was to compare the outcome of standard extrafascial hysterectomy and tailored radical hysterectomy as a definitive treatment of recurrent deep endometriosis. Study design: This was a descriptive study that comprised 38 patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy between 1989 and 2002 for symptomatic recurrences of deep endometriosis, after ≥1 previous surgical procedures and ovarian suppressive medical treatments. After the operation, all of the patients were given transdermal estradiol. The minimum follow-up time was 24 months. Results: Twenty-six patients underwent standard extra-fascial hysterectomy (group A), and 12 patients underwent modified radical hysterectomy that included the removal of all deeply infiltrating endometriotic lesions (group B). The recurrence of pain caused by endometriosis occurred in 8 women (31%) of group A and in no patients of group B. Conclusion: Definitive surgery for deep endometriosis should include the removal of the uterus, adnexa, and all surgically accessible deep lesions. As a consequence, the surgeon must be familiar with radical pelvic surgery.
AB - Objective: The purpose of this study was to compare the outcome of standard extrafascial hysterectomy and tailored radical hysterectomy as a definitive treatment of recurrent deep endometriosis. Study design: This was a descriptive study that comprised 38 patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy between 1989 and 2002 for symptomatic recurrences of deep endometriosis, after ≥1 previous surgical procedures and ovarian suppressive medical treatments. After the operation, all of the patients were given transdermal estradiol. The minimum follow-up time was 24 months. Results: Twenty-six patients underwent standard extra-fascial hysterectomy (group A), and 12 patients underwent modified radical hysterectomy that included the removal of all deeply infiltrating endometriotic lesions (group B). The recurrence of pain caused by endometriosis occurred in 8 women (31%) of group A and in no patients of group B. Conclusion: Definitive surgery for deep endometriosis should include the removal of the uterus, adnexa, and all surgically accessible deep lesions. As a consequence, the surgeon must be familiar with radical pelvic surgery.
KW - Endometriosis
KW - Radical hysterectomy
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U2 - 10.1016/j.ajog.2004.12.085
DO - 10.1016/j.ajog.2004.12.085
M3 - Article
C2 - 16021068
AN - SCOPUS:22244466432
VL - 193
SP - 114
EP - 117
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 1
ER -