title: Follow-up of laparoscopic treatment of stage III-IV endometriosis.
abstract: OBJECTIVE
  To evaluate the efficacy of conservative laparoscopic surgery in a series of patients with stage III-IV endometriosis.
  
  
  METHODS
  Prospective study (Canadian Task Force classification II-1).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  All 141 women who underwent conservative operative laparoscopy for stage III-IV endometriosis between January 1993 and December 1996 and were followed for a minimum of 6 months.
  
  
  METHODS
  Laparoscopic procedures performed with scissors, bipolar coagulation, and hydrodissection.
  
  
  RESULTS
  Clinical examination, transvaginal ultrasonography, and pain questionnaire were scheduled every 6 months postoperatively. The cumulative proportion of pregnant patients and cumulative recurrence rate were calculated by Kaplan-Meier method. Twenty-five women (44%) with infertility became pregnant. Twenty-three (51%) had stage III and two (16.7%, p <0.05) had stage IV endometriosis. The 24-month cumulative pregnancy rate was 57.5%. Thirty-one women (22%) reported pain recurrence during follow-up. Five (3.5%) recurrences were confirmed by histologic examination and eight (5.7%) were documented only by clinical and ultrasonographic findings. No recurrence occurred in the first 6 months of follow-up.
  
  
  CONCLUSIONS
  Operative laparoscopy seems to be effective treatment for stage III endometriosis. A larger series with longer follow-up is necessary to clarify its role in the management of stage IV disease. (J Am Assoc Gynecol Laparosc 6(1):55-58, 1999)
authors.affiliation: Second Department of Obstetrics and Gynecology, University of Milan, Via Commenda 12, 20122 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Busacca
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: B
authors.initials: B
authors.lastname: Agnoli
authors.forename: M
authors.initials: M
authors.lastname: Candiani
authors.forename: C
authors.initials: C
authors.lastname: Calia
authors.forename: S
authors.initials: S
authors.lastname: De Marinis
authors.forename: M
authors.initials: M
authors.lastname: Vignali
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D012008:Recurrence