1. Feasibility and safety of laparoscopic approach in obese patients with endometriosis: a multivariable regression analysis
- Author
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Manuela Mastronardi, Marco Petrillo, Renato Seracchioli, Giulia Mattioli, Simona Del Forno, Giulia Borghese, Alessandro Arena, Diego Raimondo, Eugenia Degli Esposti, Mohamed Mabrouk, Ivano Raimondo, Salvatore Dessole, Raimondo, Diego, Raimondo, Ivano, Degli Esposti, Eugenia, Mattioli, Giulia, Mastronardi, Manuela, Petrillo, Marco, Dessole, Salvatore, Mabrouk, Mohamed, Del Forno, Simona, Arena, Alessandro, Borghese, Giulia, and Seracchioli, Renato
- Subjects
Univariate analysis ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Endometriosis ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Obesity ,Surgery ,Endometriosis · Minimal access surgery · Obesity · Safety · Feasibility ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Classification of obesity ,030220 oncology & carcinogenesis ,Cohort ,medicine ,Complication ,business ,Body mass index - Abstract
Purpose To evaluate the feasibility and safety of laparoscopic excision of endometriotic lesions in obese women. Methods Retrospective analysis of prospectively collected data involving consecutive women scheduled for complete laparoscopic removal of macroscopic endometriotic lesions between January 2012 and November 2018. Operative time, laparotomic conversion rates, complication rates, and length of hospital stay were recorded. Results One thousand two hundred thirty women were enrolled and divided into two main groups, according to the World Health Organization classification of obesity, obese (body mass index ≥ 30 kg/m2) and non-obese (body mass index < 30 kg/ m2). During the study period, 91 (7.4% of overall study cohort) obese women underwent surgery. At univariate analyses, significant differences between the two groups were found in terms of age, rates of severe endometriosis, American Society of Anesthesiologists physical status classification ≥ III, and different surgical procedures. Significant differences in terms of median operative time [125 (interquartile range (IQR) 85–165) in obese group vs 110 min (IQR 75–155) in non-obese group, P = 0.04] were observed. There were no significant differences between the obese and non-obese groups with respect to the other variables of interest. After adjusted multivariable regression models for potential confounders, difference in operating time (coefficient of 13.389; 95% CI 1.716, 25.060) was still found to be significant. Conclusion In our tertiary care referral center, laparoscopic removal of endometriosis is feasible and safe, except for a slight increase of operative time and conversion rate.
- Published
- 2020
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