DIE Complex and Requires Interdisciplinary Approach

Study highlights the importance of conducting DIE surgery in specialized endometriosis centers.

Key Points

Highlights: 

• Most cases of DIE are treated with minimally invasive laparoscopic surgery.
• A high number of cases require a multidisciplinary approach.

Importance:

• The findings highlight the complexity of the disease and the importance of treating it in specialized centers.

What’s done here:

• The challenges associated with the diagnosis and treatment of DIE at an endometriosis center in Germany were retrospectively described.

Key results:

• 94.1% of DIE cases were treated with minimally invasive laparoscopy.
• Ureterolysis, adhesiolysis, or preparation of the rectovaginal septum were also considered to be standard procedures.
• 28% of cases required an interdisciplinary approach.
• Severe complications following surgery arose in 3.1% of cases.
• The complication rate was significantly higher when bowel surgery was needed. 

Limitations:

• The retrospective nature of the study is a limitation. Furthermore, the long-term results of the surgery are unknown.

Lay Summary

The vast majority of deep infiltrating endometriosis (DIE) cases are treated with minimally invasive laparoscopic surgery according to a new study published in the Journal of Clinical Medicine. Moreover, there is a high need for interdisciplinary operations.

“Our results emphasize the complexity and interdisciplinary nature of the disease,” the authors of the study concluded. “Therefore, treatment should preferably take place at an endometriosis center of the highest level with experienced, well-coordinated teams”.

The study, led by Dr. Jürgen Andress from the Department of Gynecology and Obstetrics at University Hospital Tuebingen, Germany retrospectively describes the challenges associated with the diagnosis and treatment of DIE at an endometriosis center in Germany.

The researchers also analyzed complications arising during and after surgery.

In 94.1% of cases, the treatment of DIE was performed with minimally invasive laparoscopy. Other procedures such as ureterolysis to free the ureter, adhesiolysis or the removal of adhesions, or preparation of the rectovaginal septum were also considered standard.

In 28% of cases, multidisciplinary operations were necessary highlighting the complexity of the treatment.

Severe complications following surgery developed in 3.1% of cases. The complication rate was significantly higher when bowel surgery was required.

Research Source: https://pubmed.ncbi.nlm.nih.gov/39597928/