Long-term outcomes on quality of life in women submitted to laparoscopic treatment for bowel endometriosis

Abstract

Study objective: To evaluate the long-term effects of laparoscopic surgery on quality of life in women with bowel endometriosis.

Design: Observational prospective cohort study (Canadian Task Force classification II).

Setting: Central Hospital of Santa Casa, Sao Paulo, Brazil.

Patients: Forty-five patients answered a short-form, 36-item, quality-of-life questionnaire (SF-36) at 3 different times.

Interventions: Between June 2007 and September 2008, patients underwent laparoscopic surgery to treat deep infiltrative endometriosis, with colorectal resection.

Measurements and main results: Forty-five patients with bowel endometriosis were followed up from 2007 to 2012. Before surgery, all patients exhibited signs suggestive of bowel endometriosis at magnetic resonance imaging and transrectal ultrasound. The patients underwent laparoscopic surgery for resection of the endometriosis lesions, including colorectal resection. The patients completed the questionnaire before surgery (T0), at 12 (T12) and 48 (T48) months after surgery. The 8 items of the SF-36 questionnaire at the different time points of application were compared. For each domain attribute, a score of 0 to 100 was assigned, where 0 signified the worst quality of life, and 100 the best. Statistical analysis was performed using analysis of variance. If differences were detected, multiple comparisons were performed using the Tukey test. Analysis of each domain revealed improved quality of life when comparing the period before surgery with 12 and 48 months after surgery. There was a significant increase (p < .001) in the scores in all of the SF-36 domains when comparing T0 vs T12 and T0 vs T48, with higher average scores at T48 corresponding to the domains of physical functioning, role physical, and social functioning (scores of 85.56, 75.69, and 73.61, respectively).

Conclusion: Laparoscopic treatment of bowel endometriosis improved the long-term quality of life of patients.

Keywords: Endometriosis/surgery; Follow-up; Laparoscopy; Quality of life.