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Laparoscopic appendectomy in patients with endometriosis
Bulent Berker1, Nanette Lashay, Romina Davarpanah
1Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Palo Alto, California 94304, USA.
Journal of Minimally Invasive Gynecology
|June 1, 2005
Summary
In women with endometriosis and pelvic pain, nearly half of those undergoing appendectomy had underlying appendiceal pathology. This suggests the appendix may contribute to pain in endometriosis patients.
Area of Science:
- Gynecologic Surgery
- Gastroenterology
- Pathology
Background:
- Endometriosis is a common condition associated with chronic pelvic pain.
- The role of the appendix in pelvic pain, particularly in the context of endometriosis, is not fully understood.
- Surgical management of endometriosis often involves laparoscopic procedures.
Purpose of the Study:
- To determine the frequency and types of appendiceal diseases found during surgery for endometriosis.
- To investigate the potential contribution of appendiceal pathology to pelvic pain in women with endometriosis.
Main Methods:
- Retrospective chart review of 231 women undergoing appendectomy during laparoscopic surgery for endometriosis.
- Data collected from a tertiary referral center between January 1994 and July 2004.
- Canadian Task Force classification II-3 study design.
Main Results:
- Appendiceal pathology was identified in 115 out of 231 patients (49.8%) who underwent appendectomy for endometriosis.
- Histologically proved diseases of the appendix were present in a significant proportion of these patients.
- This indicates a high rate of concomitant appendiceal pathology.
Conclusions:
- The appendix may be involved in the pathophysiology of chronic pelvic pain in patients with endometriosis.
- Appendiceal diseases should be considered in the differential diagnosis of pelvic pain in women with endometriosis.
- Laparoscopic appendectomy may be a relevant intervention in select cases.