Journal of pediatric and adolescent gynecology · 2025
Intraoperative Care and Complications of Symptomatic Adolescent and Young Adult Patients Undergoing Laparoscopy to Diagnose and/or to Treat Endometrioses: A Multi-Institutional Review.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Evans Jacquelyn R, Bergus Katherine, Asti Lindsey, Breech Lesley L, Cen Ruiqi, Gong Yuan Yuan, Paige Hertweck S, Hoefgen Holly R, Horne Anne H, Lawson Ashli, Menon Seema, O'Brien Kathleen E, Pradhan Shashwati, Rachwal Brenna, Smith Yolanda R, Suvarna Priya, Van Son Sarah, Hewitt Geri
Аннотация
STUDY OBJECTIVE: This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.
METHODS: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.
RESULTS: There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common procedures performed concurrently included LNG-IUS placement (58.10%), ovarian cystectomy (11.27%), endoscopy (1.76%), and appendectomy (1.41%). Most patients (86.27%) experienced no postoperative complications within 30 days of the procedure. Significant postoperative pain was seen in 14 patients (4.93%) with 9 patients (3.17%) requiring additional narcotics and 5 patients (1.76%) requiring admission for pain control. One patient experienced a venous thromboembolism (0.35%). Reoperation rate was 12.32% with a median interval of 1.7 years (IQR: 0.93, 4) from initial surgery.
CONCLUSIONS: We demonstrate that laparoscopy for diagnosis and/or treatment of endometriosis has low complication and reoperation rates in adolescent and young adult patients. Performing concurrent indicated procedures, particularly LNG-IUS placement, is safe and should be considered to avoid additional anesthesia exposure and cost. Anticipatory guidance regarding postoperative pain may be beneficial in this patient population. This evidence-based data aids in shared medical decision-making.
METHODS: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.
RESULTS: There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common procedures performed concurrently included LNG-IUS placement (58.10%), ovarian cystectomy (11.27%), endoscopy (1.76%), and appendectomy (1.41%). Most patients (86.27%) experienced no postoperative complications within 30 days of the procedure. Significant postoperative pain was seen in 14 patients (4.93%) with 9 patients (3.17%) requiring additional narcotics and 5 patients (1.76%) requiring admission for pain control. One patient experienced a venous thromboembolism (0.35%). Reoperation rate was 12.32% with a median interval of 1.7 years (IQR: 0.93, 4) from initial surgery.
CONCLUSIONS: We demonstrate that laparoscopy for diagnosis and/or treatment of endometriosis has low complication and reoperation rates in adolescent and young adult patients. Performing concurrent indicated procedures, particularly LNG-IUS placement, is safe and should be considered to avoid additional anesthesia exposure and cost. Anticipatory guidance regarding postoperative pain may be beneficial in this patient population. This evidence-based data aids in shared medical decision-making.