Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery
Abstract Deep endometriosis (DE) occurs in 15–30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25–49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present s...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-04-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-11179-8 |
| _version_ | 1811289430495854592 |
|---|---|
| author | Meritxell Gracia Cristian de Guirior Marta Valdés-Bango Mariona Rius Cristina Ros Isabel Matas Marta Tortajada María Ángeles Martínez-Zamora Lara Quintas Francisco Carmona |
| author_facet | Meritxell Gracia Cristian de Guirior Marta Valdés-Bango Mariona Rius Cristina Ros Isabel Matas Marta Tortajada María Ángeles Martínez-Zamora Lara Quintas Francisco Carmona |
| author_sort | Meritxell Gracia |
| collection | DOAJ |
| description | Abstract Deep endometriosis (DE) occurs in 15–30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25–49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien–Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.50% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI 1.90–11.30; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Adenomyosis is an independent preoperative risk factor for surgical complications in DE surgery after adjustment for known demographic, clinical and surgical risk factors. |
| first_indexed | 2024-04-13T03:54:41Z |
| format | Article |
| id | doaj.art-82b98bf8372340c2a30d2dd544d05130 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T03:54:41Z |
| publishDate | 2022-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-82b98bf8372340c2a30d2dd544d051302022-12-22T03:03:41ZengNature PortfolioScientific Reports2045-23222022-04-011211810.1038/s41598-022-11179-8Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgeryMeritxell Gracia0Cristian de Guirior1Marta Valdés-Bango2Mariona Rius3Cristina Ros4Isabel Matas5Marta Tortajada6María Ángeles Martínez-Zamora7Lara Quintas8Francisco Carmona9Endometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaEndometriosis Unit, ICGON, Hospital Clinic of Barcelona, University of BarcelonaAbstract Deep endometriosis (DE) occurs in 15–30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25–49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien–Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.50% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI 1.90–11.30; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Adenomyosis is an independent preoperative risk factor for surgical complications in DE surgery after adjustment for known demographic, clinical and surgical risk factors.https://doi.org/10.1038/s41598-022-11179-8 |
| spellingShingle | Meritxell Gracia Cristian de Guirior Marta Valdés-Bango Mariona Rius Cristina Ros Isabel Matas Marta Tortajada María Ángeles Martínez-Zamora Lara Quintas Francisco Carmona Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery Scientific Reports |
| title | Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| title_full | Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| title_fullStr | Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| title_full_unstemmed | Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| title_short | Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| title_sort | adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery |
| url | https://doi.org/10.1038/s41598-022-11179-8 |
| work_keys_str_mv | AT meritxellgracia adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT cristiandeguirior adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT martavaldesbango adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT marionarius adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT cristinaros adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT isabelmatas adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT martatortajada adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT mariaangelesmartinezzamora adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT laraquintas adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery AT franciscocarmona adenomyosisisanindependentriskfactorforcomplicationsindeependometriosislaparoscopicsurgery |