Agreement between the preoperative findings and the operative diagnosis in patients with deep endometriosis

Abstract

Introduction: During the evaluation of patients with endometriosis, recognizing the location and characteristics of lesions is fundamental to define the type and evaluate the response of treatment, as well as for the preoperative surgical planning. However, the non-invasive diagnostic tests have specific limitations making the diagnostic laparoscopy been recommended as a tool necessary for the diagnosis of endometriosis lesions despite the high cost and the risks involved in this procedure.

Objective: To evaluate the feasibility of mapping endometriosis lesions using clinical signs and image evaluation, comparing the pre- and postoperative findings of patients submitted to surgical treatment.

Method: A retrospective and prospective study included all patients who underwent surgical treatment for deep endometriosis between March 2011 and November 2014, at two centers of endometriosis in Rio de Janeiro. The positive finds registered during the clinical and image evaluation were compared with the surgical and histopathological results using a new instrument: the Lasmar's MAP of endometriosis

Results: 46 patients were included, age ranging from 23 to 47 years. For each site of endometriosis lesions, sensitivity, specificity, positive and negative predictive value, the positive and negative likelihood ratios and accuracy were calculated.

Discussion: The results show a high sensitivity, specificity and accuracy of the preoperative clinical evaluation to identify the main sites of endometriosis lesions without the use of diagnostic laparoscopy.

Keywords: Diagnosis; Endometriosis; Endometriosis map; Laparoscopy; Treatment.