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Surgical Treatment Affects Perceived Stress Differently in Women With Endometriosis: Correlation With Severity of Pain
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Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253
Measurements and Main Results: Laparoscopy revealed a large amount of chocolate-colored ascetic fluid, which was drained and amounted to 8.2 liters. Severe adhesive disease was noted throughout the abdomen and pelvis, including adhesions between the rectum and uterus, tubes, and ovaries obliterating these pelvic organs.
the Gastrointestinal Quality of Life Index (GICLI) and the DITROVIE scale. Measurements and Main Results: We included 172 patients with shaving (57.7%). The long-term follow-up was 81.2month +/ - 54.7. Shaving was performed for large nodules (3.6cm +/- 1.1), in the majority by laparoscopy. Patients noted an improvement in symptoms, particularly in pelvic pain, dysmenorrhea, dyschesia, dyspareunia and rectal bleeding. Post operative complications occured in 29 patients, including 23 minor (13.37%), 7 major (4%). Only two patients were operated after shaving. The cumulative pregnancy rate was 72.8%. Conclusion: When it is possible, conservative treatment is better, and should be recommended, since the complication rate was significantly lower with further chance of pregnancy.
618
The omentum was thickened throughout. Dense adhesions were noted in the perihepatic space.
Final pathology revealed largely necrotic soft tissue with viable areas of proliferative endometrium, consistent with endometriosis (stage IV). Postoperatively, the patient recovered with no complications. She began a course of gonadotropin releasing hormone agonist with estrogen add-back therapy, under close surveillance. Conclusion: In women of reproductive age, endometriosis must be considered in the work-up of hemorrhagic ascites. Symptoms may be nonspecific and limited to abdominal girth, fullness, dysmenorrhea, or weight changes; however, the disease process is typically advanced with dense intra-abdominal and pelvic adhesions. Definitive diagnosis is made with diagnostic laparoscopy. Medical treatment with ovarian function suppression is preferred.
617 Long-Term Evaluation of Clinical Results and Quality of Life for Deeply Infiltrating Pelvic Endometriosis Canis M,1 Bouchet P,1 Botchorichvili R,1 Bourdel N,1 Pouly J-L,1 Slim K.2 1 Department of Gynecology and Obstetrics, CHU de Clermont Ferrand, Clermont-Ferrand, France; 2Department of Digestive and General Surgery, CHU de Clermont Ferrand, Clermont-Ferrand, France Study Objective: Surgery for deep endometriosis with rectal muscularis involvement is controversial. We use a shaving method whenever possible. The present study was undertaken to assess long term clinical follow up after our surgical approach. Design: Retrospective qualitative study. Setting: Tertiary referral center of Clermont Ferrand (France). Patients: 298 patients were treated by the shaving laparoscopic technique for a rectovaginal nodule, more than 2 centimeters in diameter,from January 2000 to June 2013. 33 patients with bowel resection were not included. Personal data were reviewed. Preoperative symptoms, operative and pathological data, pre- and post-operative complications, recurrence and fertility were collected. Clinical results were assessed, using validated research tools: visual analogue pain scale, the Short Form SF36v2 scale,
Surgical Treatment Affects Perceived Stress Differently in Women With Endometriosis: Correlation With Severity of Pain Lazzeri L, Centini G, Vannuccini S, Orlandini C, Petraglia F, Zupi E. Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy Study Objective: To investigate the amount of perceived stress in a group of women with different forms of endometriosis-related pain before and after surgical treatment. Design: Prospective clinical trial. Setting: University hospital. Patients: A group of women (n = 98) referred to our center for chronic pain and suspected of having endometriosis. Intervention: All women suspected of having endometriosis with ultrasonography underwent to a clinical evaluation including assessment of perception of stress. Endometriosis was confirmed histologically by laparoscopy. ainful symptoms and perception of stress were recorded 1 month after surgery. Measurements and Main Results: Perceived stress scale (PSS) and visual analog scale for painful symptoms before and 1 month after surgery for endometriosis.The PSS score before surgery was perceived as ‘‘very high’’ in patients with deep endometriosis (n = 20) or deep endometriosis associated with endometrioma (n = 21); ‘‘high’’ or ‘‘medium’’ PSS was perceived in patients with endometrioma (n = 34) or endometrioma associated with peritoneal endometriosis (n = 23). After the surgical treatment a significant decrease of the ‘‘very high’’ PSS score was shown, as well as when the entire group of patients was considered. When evaluated before and after surgery, according to the severity of pain (dysmenorrhea, dyspareunia, and pelvic pain), a direct correlation was found with the level of PSS. Conclusion: Patients with deep endometriosis-related pain (dysmenorrhea, pelvic pain, dyspareunia) showed the highest level of perceived stress, which significantly decreased after surgical treatment.
619 Outcomes of the Surgical Treatment of Endometriosis Affecting the Right Colon and Appendix: A Series of 34 Patients Queiroz CE,1 Medeiros BA,1 Furtado SP,1 Araujo MT,1 Pinto PJ,2 Castro NM.2 1NEC - Nucleo de Endometriose do Ceara, Hospital Regional Unimed, Fortaleza, CE, Brazil; 2IPADE - Instituto para Desenvolvimento da Educac¸~ao, Centro Universitario Christus - Campus Parque Ecologico, Fortaleza, CE, Brazil Study Objective: To present a series report of deep infiltrating endometriosis involving the appendix and the right colon. Design: Patients submitted to surgery procedure due to deep infiltrating endometriosis involving the rectum, and, intra-operatively, had detected disease involving the appendix, terminal ileum and/or cecum. Data
Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253
Measurements and Main Results: Laparoscopy revealed a large amount of chocolate-colored ascetic fluid, which was drained and amounted to 8.2 liters. Severe adhesive disease was noted throughout the abdomen and pelvis, including adhesions between the rectum and uterus, tubes, and ovaries obliterating these pelvic organs.
the Gastrointestinal Quality of Life Index (GICLI) and the DITROVIE scale. Measurements and Main Results: We included 172 patients with shaving (57.7%). The long-term follow-up was 81.2month +/ - 54.7. Shaving was performed for large nodules (3.6cm +/- 1.1), in the majority by laparoscopy. Patients noted an improvement in symptoms, particularly in pelvic pain, dysmenorrhea, dyschesia, dyspareunia and rectal bleeding. Post operative complications occured in 29 patients, including 23 minor (13.37%), 7 major (4%). Only two patients were operated after shaving. The cumulative pregnancy rate was 72.8%. Conclusion: When it is possible, conservative treatment is better, and should be recommended, since the complication rate was significantly lower with further chance of pregnancy.
618
The omentum was thickened throughout. Dense adhesions were noted in the perihepatic space.
Final pathology revealed largely necrotic soft tissue with viable areas of proliferative endometrium, consistent with endometriosis (stage IV). Postoperatively, the patient recovered with no complications. She began a course of gonadotropin releasing hormone agonist with estrogen add-back therapy, under close surveillance. Conclusion: In women of reproductive age, endometriosis must be considered in the work-up of hemorrhagic ascites. Symptoms may be nonspecific and limited to abdominal girth, fullness, dysmenorrhea, or weight changes; however, the disease process is typically advanced with dense intra-abdominal and pelvic adhesions. Definitive diagnosis is made with diagnostic laparoscopy. Medical treatment with ovarian function suppression is preferred.
617 Long-Term Evaluation of Clinical Results and Quality of Life for Deeply Infiltrating Pelvic Endometriosis Canis M,1 Bouchet P,1 Botchorichvili R,1 Bourdel N,1 Pouly J-L,1 Slim K.2 1 Department of Gynecology and Obstetrics, CHU de Clermont Ferrand, Clermont-Ferrand, France; 2Department of Digestive and General Surgery, CHU de Clermont Ferrand, Clermont-Ferrand, France Study Objective: Surgery for deep endometriosis with rectal muscularis involvement is controversial. We use a shaving method whenever possible. The present study was undertaken to assess long term clinical follow up after our surgical approach. Design: Retrospective qualitative study. Setting: Tertiary referral center of Clermont Ferrand (France). Patients: 298 patients were treated by the shaving laparoscopic technique for a rectovaginal nodule, more than 2 centimeters in diameter,from January 2000 to June 2013. 33 patients with bowel resection were not included. Personal data were reviewed. Preoperative symptoms, operative and pathological data, pre- and post-operative complications, recurrence and fertility were collected. Clinical results were assessed, using validated research tools: visual analogue pain scale, the Short Form SF36v2 scale,
Surgical Treatment Affects Perceived Stress Differently in Women With Endometriosis: Correlation With Severity of Pain Lazzeri L, Centini G, Vannuccini S, Orlandini C, Petraglia F, Zupi E. Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy Study Objective: To investigate the amount of perceived stress in a group of women with different forms of endometriosis-related pain before and after surgical treatment. Design: Prospective clinical trial. Setting: University hospital. Patients: A group of women (n = 98) referred to our center for chronic pain and suspected of having endometriosis. Intervention: All women suspected of having endometriosis with ultrasonography underwent to a clinical evaluation including assessment of perception of stress. Endometriosis was confirmed histologically by laparoscopy. ainful symptoms and perception of stress were recorded 1 month after surgery. Measurements and Main Results: Perceived stress scale (PSS) and visual analog scale for painful symptoms before and 1 month after surgery for endometriosis.The PSS score before surgery was perceived as ‘‘very high’’ in patients with deep endometriosis (n = 20) or deep endometriosis associated with endometrioma (n = 21); ‘‘high’’ or ‘‘medium’’ PSS was perceived in patients with endometrioma (n = 34) or endometrioma associated with peritoneal endometriosis (n = 23). After the surgical treatment a significant decrease of the ‘‘very high’’ PSS score was shown, as well as when the entire group of patients was considered. When evaluated before and after surgery, according to the severity of pain (dysmenorrhea, dyspareunia, and pelvic pain), a direct correlation was found with the level of PSS. Conclusion: Patients with deep endometriosis-related pain (dysmenorrhea, pelvic pain, dyspareunia) showed the highest level of perceived stress, which significantly decreased after surgical treatment.
619 Outcomes of the Surgical Treatment of Endometriosis Affecting the Right Colon and Appendix: A Series of 34 Patients Queiroz CE,1 Medeiros BA,1 Furtado SP,1 Araujo MT,1 Pinto PJ,2 Castro NM.2 1NEC - Nucleo de Endometriose do Ceara, Hospital Regional Unimed, Fortaleza, CE, Brazil; 2IPADE - Instituto para Desenvolvimento da Educac¸~ao, Centro Universitario Christus - Campus Parque Ecologico, Fortaleza, CE, Brazil Study Objective: To present a series report of deep infiltrating endometriosis involving the appendix and the right colon. Design: Patients submitted to surgery procedure due to deep infiltrating endometriosis involving the rectum, and, intra-operatively, had detected disease involving the appendix, terminal ileum and/or cecum. Data