Follow-up of laparoscopic treatment of stage III-IV endometriosis.
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)
Busacca
M
M
Second Department of Obstetrics and Gynecology, University of Milan, Via Commenda 12, 20122 Milan, Italy.
Bianchi
S
S
Agnoli
B
B
Candiani
M
M
Calia
C
C
De Marinis
S
S
Vignali
M
M
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