Endometriosis Severity and Complication Risks Following Laparoscopic Surgery

The reason no associations were found between disease severity and risk of complications following endometriosis surgery could be because no adequate imaging was available, authors say.

Key Points

Highlights:

• The lack of association between the disease severity and risk of complications following endometriosis surgery may be due to the lack of adequate imaging.

Importance:

• It is important to incorporate the right imaging strategies before endometriosis surgery so complexities can be predicted and complications mitigated.

What's done here:

• Researchers questioned the validity of the findings of the study based on their past knowledge.

Key results:

• Pelvic ultrasound assessment beyond what is recommended by the American Institute of Ultrasound in Medicine should be performed before surgery to estimate disease severity and the potential risk of complications. 

Lay Summary

In a research article published in the journal Acta Obstetricia et Gynecologica Scandinavica, researchers at Brigham and Women's Hospital in Boston, Massachusetts suggested that the severity of endometriosis could not be a predictor of the risk of post-operative complications.

In a letter to the editor of the same journal, researchers at the University of Sidney say that this could be due to the lack of adequate imaging before the operation.

Imaging techniques such as magnetic resonance imaging (MRI) and ultrasound can be used to predict the severity of endometriosis. According to Australian researchers, the integration of these imaging techniques in the study’s patient population is unclear.

For example, they say, the definition of endometriotic implants as seen by MRI or ultrasound is not properly laid out. They add that no explanation is given about why one or the other imaging technique is used.

They also say that it is not clear what is being evaluated during the imaging and question the expertise of the operator doing the evaluation. They, therefore, report that it is not possible to conclude that pre-operative imaging cannot predict the risk of complications following surgery. 

“We have demonstrated that ultrasound can predict the surgical complexity using the Ultrasound-based Endometriosis Staging System (or UBESS)”, the authors write. They add that because the researchers do not mention this point, their article may mislead readers to think that it is not possible to predict the risk of complications before surgery.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31729759