Objectives:
DIE is the most challenging type of endometriosis and laparoscopic surgery is considered
gold standard. In order to achieve a complete resection extensive surgical procedures
have to be performed in the majority of DIE patients. The aim of this project was
to retrospectively identify DIE patients treated at our hospital and to study surgical
treatment at a large single centre endometriosis clinic.
Materials and methods:
A retrospective chart review was performed in all patients surgically treated for
deep infiltrating endometriosis at the Tuebingen University Women's hospital during
2005 to 2015.
Results:
524 patients underwent DIE surgery, in all cases a laparoscopic approach was chosen.
In 2.1% a conversion to open surgery was necessary due to extensive adhesions resulting
from previous surgeries. Mean duration of DIE-surgery was 149.3 minutes, a complete
resection was possible in 98.6% of cases. In 42% of cases extended intestinal procedures
such as bowel-shaving (25.2%), segment resection (6.3%) and disc resection (2.1%)
were necessary. Extended urological procedures had to be performed in 12.6% of cases
with partial resection and new implantation of the ureter in 4.2% of cases.
Conclusion:
Our study could show that although complex surgery to completely resect DIE is needed
this can be done laparoscopically. This emphasizes the need to perform surgical treatment
for DIE in specialized endometriosis centers with an interdisciplinary approach. Clinical
follow-up studies will allow us to investigate recurrence rates and the impact of
DIE surgery on pain relief and pregnancy outcome.
