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Feasibility and safety of laparoscopic approach in obese patients with endometriosis: a multivariable regression analysis

Archives of Gynecology and Obstetrics volume 302, pages 665–670 (2020)Cite this article

Abstract

Purpose

To evaluate the feasibility and safety of laparoscopic excision of endometriotic lesions in obese women.

Methods

Retrospective analysis of prospectively collected data involving consecutive women scheduled for complete laparoscopic removal of macroscopic endometriotic lesions between January 2012 and November 2018. Operative time, laparotomic conversion rates, complication rates, and length of hospital stay were recorded.

Results

One thousand two hundred thirty women were enrolled and divided into two main groups, according to the World Health Organization classification of obesity, obese (body mass index ≥ 30 kg/m2) and non-obese (body mass index < 30 kg/m2). During the study period, 91 (7.4% of overall study cohort) obese women underwent surgery. At univariate analyses, significant differences between the two groups were found in terms of age, rates of severe endometriosis, American Society of Anesthesiologists physical status classification ≥ III, and different surgical procedures. Significant differences in terms of median operative time [125 (interquartile range (IQR) 85–165) in obese group vs 110 min (IQR 75–155) in non-obese group, P = 0.04] were observed. There were no significant differences between the obese and non-obese groups with respect to the other variables of interest. After adjusted multivariable regression models for potential confounders, difference in operating time (coefficient of 13.389; 95% CI 1.716, 25.060) was still found to be significant.

Conclusion

In our tertiary care referral center, laparoscopic removal of endometriosis is feasible and safe, except for a slight increase of operative time and conversion rate.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, DIMEC, S. Orsola Hospital, University of Bologna, Massarenti, 13, 40138, Bologna, Italy

    Diego Raimondo, Eugenia Degli Esposti, Giulia Mattioli, Manuela Mastronardi, Mohamed Mabrouk, Simona Del Forno, Alessandro Arena, Giulia Borghese & Renato Seracchioli

  2. Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy

    Ivano Raimondo, Marco Petrillo & Salvatore Dessole

  3. School in Biomedical Sciences, University of Sassari, Sassari, Italy

    Ivano Raimondo, Marco Petrillo & Salvatore Dessole

  4. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Cambridge Clinical School, The Rosie Hospital, Robinson Way, Box 223, Cambridge, CB2 0SW, UK

    Mohamed Mabrouk

Authors
  1. Diego Raimondo
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  2. Ivano Raimondo
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  3. Eugenia Degli Esposti
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  4. Giulia Mattioli
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  5. Manuela Mastronardi
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  6. Marco Petrillo
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  7. Salvatore Dessole
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  8. Mohamed Mabrouk
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  9. Simona Del Forno
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  10. Alessandro Arena
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  11. Giulia Borghese
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  12. Renato Seracchioli
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Contributions

Conceptualization: DR. Methodology: IR, MP. Formal analysis and investigation: GM, EDE, MM. Writing—original draft preparation: DR, AA, GB. Writing—review and editing: MM, SDF. Supervision: RS, SD.

Corresponding author

Correspondence to Eugenia Degli Esposti.

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Conflict of interest

The authors declare that they have no conflicts of interest and nothing to disclose.

Informed consent

Informed consent was obtained from all individual participants included in the study at time of preoperative evaluation.

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The study was registered on ClinicalTrial.gov with the following ID number: NCT0389935 (https://clinicaltrials.gov/ct2/show/NCT03899935).

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Raimondo, D., Raimondo, I., Degli Esposti, E. et al. Feasibility and safety of laparoscopic approach in obese patients with endometriosis: a multivariable regression analysis. Arch Gynecol Obstet 302, 665–670 (2020). https://doi.org/10.1007/s00404-020-05629-9

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  • DOI: https://doi.org/10.1007/s00404-020-05629-9

Keywords

  • Endometriosis
  • Minimal access surgery
  • Obesity
  • Safety
  • Feasibility