title: Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications.
abstract: OBJECTIVE
  To study severe endometriosis as a cause of pelvic pain, which represents one of the most challenging disorders in gynecology.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Teaching hospital.
  
  
  METHODS
  A total of 1,363 women with severe endometriosis (revised American Society for Reproductive Medicine [rASRM] stage IV).
  
  
  METHODS
  A detailed survey of all patients with severe endometriosis (rASRM stage IV) who underwent laparoscopy at our center between January 2004 and December 2007 was carried out.
  
  
  METHODS
  Clinical and surgical data were retrieved and assessed according to the extent of surgery performed. Intraoperative, ultra-short, and short-term clinical complications were assessed.
  
  
  RESULTS
  A total of 1,201 women underwent laparoscopic radical surgery with excision of all visible endometriotic lesions, with a significant improvement of symptoms at 1-month follow-up evaluation. The overall intraoperative complication rate was 2.0%. The morbidity was significantly increased when bowel surgery was performed, with a risk of intraoperative complications that was threefold higher. Of the patients who had bowel surgery, 18 (4.1%) required reintervention within the first week after surgery.
  
  
  CONCLUSIONS
  We report on the safety and efficacy of laparoscopic eradication of all visible implants in cases of rASRM stage IV endometriosis when surgery is performed in a referral center.
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Gynecologic Oncology Division, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Minelli
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Gynecologic Oncology Division, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceccaroni
authors.affiliation: Department of General Surgery, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Ruffo
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Gynecologic Oncology Division, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bruni
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pomini
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Gynecologic Oncology Division, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pontrelli
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Department of Obstetrics and Gynecology, University of Parma, Parma, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Rolla
authors.affiliation: Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Department of Perinatal Medicine, Tor Vergata University, Rome, Italy. Electronic address: marcoscioscia@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Scioscia
mesh_terms: D000328:Adult; D000465:Algorithms; D015897:Comorbidity; D004715:Endometriosis / Q000145:classification / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D007410:Intestinal Diseases / Q000145:classification / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000534:rehabilitation / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome