title: 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<0.01). At the time of follow-up a higher proportion of patients in group B were 'very satisfied' than those in group A (87.7% vs 59.0%, P=0.013).
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don A.Sempreboni 5, 37024 Negrar (Verona), School of Medicine, University of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Landi
authors.forename: M
authors.initials: M
authors.lastname: Ceccaroni
authors.forename: A
authors.initials: A
authors.lastname: Perutelli
authors.forename: C
authors.initials: C
authors.lastname: Allodi
authors.forename: F
authors.initials: F
authors.lastname: Barbieri
authors.forename: A
authors.initials: A
authors.lastname: Fiaccavento
authors.forename: G
authors.initials: G
authors.lastname: Ruffo
authors.forename: E
authors.initials: E
authors.lastname: McVeigh
authors.forename: L
authors.initials: L
authors.lastname: Zanolla
authors.forename: L
authors.initials: L
authors.lastname: Minelli
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000294:innervation* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010149:Postoperative Pain; D012086:Reoperation; D013153:Splanchnic Nerves / Q000473:pathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome