Minimally Invasive Surgery Improves the Quality of Life of Women With Deep Infiltrating Endometriosis

This is the case whether they have robotic or classic surgery or conservative or total surgery.

Key Points

Highlights: 

• Minimally invasive surgery improves the quality of life of women with deep infiltrating endometriosis and reduces period pain and pain during sex.
• Robotic and classic laparoscopy leads to similar results as do conservative and total surgery.

Importance:

These findings are important as they can help patients and doctors make more informed decisions regarding endometriosis treatment.

What's done here:

Researchers analyzed a total of 54 women with deep infiltrating endometriosis who have undergone minimally invasive surgery to treat their disease.

Key results:

• There was a decrease in the EPH-5 scores of all women two years after surgery compared to before.
• The Visual Analog Scale for period pain and pain during sex was lower two years after suregery compared to before surgery.
• The EPH-5 scores of both women who underwent robotic surgery and classic laparoscopy went down two years following surgery compared to before the operation.
• The EPH-5 scores of both women who had conservative surgery and total surgery went down two years following surgery compared to before.

Limitation:

• This is a retrospective study so there may be a bias due to the loss of follow-up.
• The groups are not comparable with each other. For example, the rate of hysterectomy was much higher among women who underwent robotic surgery, which is a major bias. 

Lay Summary

Minimally invasive surgery improves the quality of life of women with deep infiltrating endometriosis two years after the operation, according to a new study published in the Journal of Clinical Medicine. The results are similar between conservative and total surgery. However, it is not clear whether robotic or classic laparoscopy is better and more research is needed to clarify this.

These findings are important as they can guide doctors and patients in making informed decisions about the best treatment approach.

In order to assess the effect of minimally invasive surgery on the quality of life of patients with deep infiltrating endometriosis, a team of researchers led by Dr. Jean-Marc Ayoubi conducted a retrospective study between January 2010 and January 2019 at Foch Hospital in Suresnes, France.

The researchers analyzed a total of 54 women with deep infiltrating endometriosis. Some of these patients had classic laparoscopy while others had robotic surgery and some patients had conservative surgery while others had total surgery. 

The results showed that the health-related quality of life of women with deep infiltrating endometriosis clearly improved following endometriosis surgery based on their Endometriosis Health Profile-5 (EPH-5) scores before the operation and two years after it.

The Visual Analogic Scale, which is a measure of the intensity of pain was also lower for painful periods and painful intercourse two years after surgery compared to before.

When they compared women who had robotic surgery to those who had classic laparoscopy, the researchers saw that the EPH-5 scores of women in both groups were reduced two years after surgery compared to before the operation, suggesting an improvement in their health-related quality of life, with a slight advantage for robotic surgery. 

Similarly, the EPH-5 scores of both women who had conservative surgery and those who had total surgery decreased two years after the operation compared to before, again suggesting an improvement in their health-related quality of life. 

The authors of the study concluded that minimally invasive surgery can help improve the quality of life of patients with pain and deep infiltrating endometriosis and significantly decrease period pain and pain during sex.

Research Source: https://pubmed.ncbi.nlm.nih.gov/36294462/