Results
Endometriosis, endometriosis, pelvic pain, dyspareunia, pain, fistula
LOW ANTERIOR RESECTION SYNDROME, ENDOMETRIOSIS, ENDOMETRIOSIS, POSTOPERATIVE COMPLICATIONS, DYSPAREUNIA, SURGICAL COMPLICATIONS, LEAKAGE, COMPLICATIONS
A total of 91 patients were enrolled in the study between 30 September 2019 and 31 December 2020, at the University Hospital, with 42 randomly assigned to the NC arm and 49 assigned to the CLR arm. One patient was lost to follow-up (Fig. The demographic and clinical characteristics of the participants are shown in Table Demographic data.Data are ASA, American Society of Anaesthesiologists score; NOSE, Natural Orifice Specimen Extraction.
Tables Intraoperative findings.Data are ASRM, American Society of Reproductive Medicine; DE, deep endometriosis; EFI, Endometriosis Fertility Index; NOSE, Natural Orifice Specimen Extraction.Postoperative surgical complications.Data are NOSE, Natural Orifice Specimen Extraction.Fisher Exact test has been executed.The intraoperative classification of endometriosis was performed according to the rASRM and ENZIAN classification systems during all proceduresWhen comparing the NC and CLR groups with regard to the rates of grade I and II postoperative complications, no statistically significant difference was found. According to the Clavien–Dindo classification, we observed two severe (grade III or higher) complications (2.27%): one anastomotic leakage in the NC group and one rectovaginal fistula in the CLR group
Table Preoperative and postoperative assessment of digestive function and quality of life.EHP30, Endometriosis Health Profile 30; GIQLI, Gastrointestinal Quality of Life Index; LARS, Low Anterior Resection Syndrome; NOSE, Natural Orifice Specimen Extraction; T0, preoperative; T3, 12 months after surgery; VAS, Visual Analogue Scale.Mann–Whitney The EHP30 scores significantly improved 12 months after the operation compared to the preoperative values in both groups. The overall GIQLI, EHP30, and LARS scores did not reveal significant differences between the two arms 12 months after surgery.
Figure Endometriosis Health Profile 30 scales (pain, emotional well-being, control and powerlessness-CP, self-image, social support, sexuality), LARS (Low Anterior Resection Syndrome) score and GIQLI (Gastrointestinal Quality of life Index) score in conventional and NOSE surgery groups preoperatively, 1 month, 6 months, and 1 year after the surgery.Regarding pain symptoms, the chronic pelvic pain, dyspareunia, and dyschezia VAS scores were significantly improved in both groups compared with the baseline scores 1 year after surgery (chronic pelvic pain: NC T0=6±5.2, T3=3±2.2, There was no statistically significant difference in the change in LARS, GIQLI, EHP30, and VAS scores between the NOSE and conventional treatment groups 12 months after surgery when compared to preoperative values (T3 minus baseline) see Table Clinical assessment 12 months after surgery.EHP30, Endometriosis Health Profile 30; GIQLI, Gastrointestinal Quality of Life Index; LARS, Low Anterior Resection Syndrome; NOSE, Natural Orifice Specimen Extraction; T0, preoperative; T3, 12 months after surgery; VAS, Visual Analog Scale.Mann–Whitney The results of follow-up assessments for each time point (T0, T1, T2, and T3) are depicted in Supplementary Table 1 (Supplemental Digital Content 2, During the 14±2.6 months of follow-up, 22 patients with active child wishes achieved pregnancy: 8 in the NC arm (21%) and 14 in the CLR arm (29%) (