Surgical Excision of Advanced Endometriosis: Perioperative Outcomes and Impacting Factors.
OBJECTIVE
To determine perioperative outcomes and factors impacting operating time, length of hospital stay, and complications of patients undergoing surgery for stage 3 or 4 endometriosis.


METHODS
Retrospective review of medical records (Canadian Task Force classification II-2).


METHODS
Mayo Clinic Hospital, Phoenix, Arizona.


METHODS
Women (n = 493) with endometriosis stage 3 and 4 undergoing surgical excision between March 15, 2005, and December 31, 2011.


METHODS
Robotic-assisted (n = 331) or laparoscopic (n = 162) excision.


METHODS
Age, body mass index, comorbidities, number and type of procedures per patient, type of surgical approach, operating time, blood loss, intraoperative and postoperative complications (within 42 days), and length of hospital stay.


RESULTS
The mean patient age was 39.5 years; body mass index, 25.9; number of procedures, 3.3; operating time, 130.4 minutes; blood loss, 88.5 mL; and hospital stay, 1.0 days. Major complications occurred in 5 patients (1.5%). Fifty-nine patients (12.0%) underwent modified radical hysterectomy, 90 (18.3%) underwent ureteral and/or intestinal resection, and 3 (0.6%) underwent diaphragm resection. Factors significantly associated with operating time included age (p = .008) and blood loss, number of procedures per patient, and robotics (all p < .001). Length of stay was affected by age, operating time, and blood loss (all p < .001). Operating time was the only significant factor associated with postoperative complications (p < .001).


CONCLUSIONS
Operating time is an independent and significant factor for postoperative complications and hospital stay.
Department of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, AZ. Electronic address: jmagrina@mayo.edu.
Javier F
JF
Magrina
Department of Gynecology, Clinica Quiron, Madrid, Spain.
Mercedes
M
Espada
Department of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, AZ.
Rosanne M
RM
Kho
Department of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, AZ.
Rachel
R
Cetta
Department of Biostatistics, Mayo Clinic, Scottsdale, AZ.
Yu-Hui H
YH
Chang
Department of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, AZ.
Paul M
PM
Magtibay
D000328:Adult; D001130:Arizona / Q000453:epidemiology; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D004715:Endometriosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D010535:Laparoscopy; D007902:Length of Stay; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome
Endometriosis; Laparoscopy; Pelvic surgery; Robotics