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RESEARCH PRODUCT

Histologic analysis of specimens from laparoscopic endometrioma excision performed by different surgeons: does the surgeon matter?

Riccardo MaranaPierluigi Benedetti PaniciGaspare CucinellaMauro BusaccaRoberto AngioliMichele VignaliLudovico MuziiAntonella Bianchi

subject

endometriosisLaparoscopic surgerymedicine.medical_treatmentEndometriosisEndometriosis laparoscopy ovarian cystsGynecologic Surgical Proceduresmorphologyovarian endometriomaMedicineSingle-Blind MethodOvarian DiseasesLaparoscopyclinical articleresidency educationmedicine.diagnostic_testmedical specialistarticleObstetrics and Gynecologyendometriosis; laparoscopy; ovarian cystsOrgan Sizelaparoscopic surgeryTumor Burdenendometrium tumorfemaleuterus surgerymedicine.anatomical_structurepriority journalstripping techniquehistopathologyClinical CompetenceAdultmedicine.medical_specialtyOvaryPhysiciansHumanshumanOvarian cystbusiness.industryOvaryHistologymedicine.diseasehuman tissuethicknessSurgeryEndoscopyadult; article; clinical article; endometriosis; endometrium tumor; female; histopathology; human; human tissue; laparoscopic surgery; medical specialist; morphology; multicenter study; ovarian endometrioma; ovary; priority journal; residency education; stripping technique; surgeon; thickness; uterus surgery Adult; Clinical Competence; Endometriosis; Female; Gynecologic Surgical Procedures; Humans; Laparoscopy; Organ Size; Ovarian Diseases; Ovary; Physicians; Single-Blind Method; Tumor Burdenmulticenter studySettore MED/40 - GINECOLOGIA E OSTETRICIAReproductive MedicinesurgeonLaparoscopyHistopathologybusiness

description

Objective To evaluate whether the amount of ovarian tissue inadvertently removed along with the endometrioma cyst wall at laparoscopy differs in relation to the operating surgeon's level of expertise. Design Multicenter, prospective trial. Setting Four tertiary care university hospitals. Patient(s) Fifty patients, aged 25 to 40 years, with monolateral ovarian endometriomas who underwent laparoscopic excision. Intervention(s) Operation with the stripping technique by surgeons with specific expertise in endometriosis surgery in four centers (groups A, B, C, and D) and by residents with average training in laparoscopic surgery (group E). Main Outcome Measure(s) Histologic examination for the evaluation of the mean thickness of the cyst wall from each specimen, and the mean thickness and morphologic characteristics of any ovarian tissue removed. Result(s) No statistically significant differences were present in the rate of presence of ovarian tissue in the endometrioma wall specimens from the different groups (44%, 45%, 55%, 56%, and 60% in groups A, B, C, D, and E, respectively). For groups A + B + C + D versus group E, a statistically significant difference was found in the mean thickness of the tissue specimens (1.51 mm vs. 1.91 mm, respectively) and in the mean thickness of ovarian tissue inadvertently excised (0.49 mm vs. 0.97 mm, respectively). Conclusion(s) Level of expertise in endometriosis surgery is inversely correlated with inadvertent removal of healthy ovarian tissue along with the endometrioma capsule.

yearjournalcountryeditionlanguage
2011-01-01
10.1016/j.fertnstert.2011.02.034http://hdl.handle.net/10447/77916