COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF LAPAROSCOPIC ORGAN-PRESERVING TREATMENT OF DEEP ENDOMETRIOSIS USING THE STANDARDIZED METHOD AND THE TRADITIONAL METHOD

Deep endometriosis is the most aggressive type of endometriosis with deep tissue infiltration, leading to disruption of the anatomy and functionality of vital organs and a decrease in the quality of life.The aim of the study. To conduct a comparative analysis of intraoperative and postoperative indicators of organ-preserving surgical treatment of women with deep endometriosis accompanied by pain syndrome, using a standardized technique and a traditional laparoscopic method.Materials and methods. A comparative study was conducted, involving 309 patients of reproductive age with pain syndrome, who underwent surgery for deep endometriosis. The main group (I clinical) consisted of 210 patients who were operated on using the standardized method proposed by us. The comparison group (II clinical) consisted of 99 patients who were operated on using the traditional laparoscopic method.Results. Improvement of intraoperative parameters was obtained in the main group, in particular, a reduction in the duration of the operation (122.32 ± 2.61 min in the main group and 148.44 ± 3.05 min in the control group, p < 0.001), reduction in blood loss (136.13 ± 2.41 ml in the main group and 174.43 ± 3.23 ml in the control group, p < 0.001); early postoperative indicators, namely, a decrease in the duration of hospital stay (in the main group 4.17 ± 0.1 days and in the control group 5.42 ± 0.16 days, p < 0.001); reduction of Clavien-Dindo class I complications (cases of postoperative intestinal paresis decreased by 4.9 times, the number of cases of urination dysfunction – by 4.2 times). In both group, no difference was found in Clavien-Dindo class II, III and IV complications. A significant reduction in pain scores was obtained 6 month after surgery in both groups, with no significant difference between the groups.Conclusions. The use of a standardized surgical intervention algorithm helps improve some intraoperative and early postoperative indicators of surgical treatment of deep endometriosis.