Rev Med UAS
Rev Med UAS; Vol. 14: No. 2. Abril-Junio 2024
ISSN 2007-8013

Recurrencia de dismenorrea en pacientes con endometriosis peritoneal tratadas con peritonectomía laparoscópica

Recurrence of dysmenorrhea in patients with peritoneal endometriosis treated with laparoscopic peritonectomy

Marco Antonio López-Zepeda1, Francisco Manuel Robles-López2, Manuel Antonio López-de la Torre1, Fred Morgan-Ortiz1,2*

  1. Hospital Puerta de Hierro en Guadalajara, Jalisco.
  2. Departamento de Ginecología y Obstetricia del Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa.

*Autor de correspondencia: Dr. Fred Morgan-Ortiz.
Eustaquio Buelna, No. 91. Col. Gabriel Leyva. CP: 80030 Culiacán Rosales, Sin.
Correo electrónico: fmorganaortiz@uas.edu.mx; Tel. 6671981873

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v14.n2.002

Texto Completo PDF

Recibido 14 de noviembre 2023, aceptado 18 de diciembre 2023

RESUMEN
Objetivo: Determinar el efecto de la peritonectomía sobre el dolor pélvico en pacientes con endometriosis.
Pacientes y método: Estudio prospectivo, longitudinal y observacional en pacientes con endometriosis peritoneal y dolor pélvico sometidas a peritonectomía en la Clínica de Excelencia de Endometriosis en Guadalajara, Jalisco. Se evaluó la intensidad del dolor mediante la escala visual análoga (EVA) antes y 12 meses después del procedimiento. También se clasificó el estadio de la enfermedad con ASRM y AAGL, y se analizaron variables secundarias como gestaciones, evolución de la dismenorrea, cirugías previas, manejo médico, duración del procedimiento, pérdida sanguínea y complicaciones.
Resultados: Se realizaron 213 procedimientos, con una edad media de 32.9 años (rango 15-54). De las pacientes, 106 (49.8%) estaban casadas y 107 (50.2%) solteras. Las nuligestas fueron 147 (69.01%) y el 46.4% de las pacientes estuvo libre de dismenorrea entre 2 y 4 años tras la cirugía. Los estadios de enfermedad fueron: rASM (I: 4.69%, II: 22.5%, III: 30.04%, IV: 42.7%) y AAGL (I: 4.69%, II: 14.55%, III: 16.43%, IV: 64.31%). La pérdida sanguínea osciló entre 10 y 700 ml, y el tiempo quirúrgico promedio fue de 177.5 minutos. La media de dolor antes y después de la cirugía fue de 9.0 y 1.0, respectivamente, con una reducción promedio de 7.9 puntos en la EVA (p<0.001).
Conclusiones: La peritonectomía laparoscópica es efectiva en el manejo de la endometriosis peritoneal, con un 46.4% de ausencia de dismenorrea a 2 años y una disminución media de 7.9 puntos en la intensidad del dolor. Palabras clave: Endometriosis, laparoscopia, dismenorrea, recurrencia.

ABSTRACT
Objective: Determine the effect of peritonectomy on pelvic pain in patients with endometriosis.
Patients and method: Prospective, longitudinal and observational study in patients with peritoneal endometriosis and pelvic pain undergoing peritonectomy at the Endometriosis Clinic of Excellence in Guadalajara, Jalisco. Pain intensity was evaluated using the visual analogue scale (VAS) before and 12 months after the procedure. The stage of the disease was also classified with ASRM and AAGL, and secondary variables such as pregnancies, evolution of dysmenorrhea, previous surgeries, medical management, duration of the procedure, blood loss and complications were analyzed.
Results: 213 procedures were performed, with a mean age of 32.9 years (range 15-54). Of the patients, 106 (49.8%) were married and 107 (50.2%) were single. Nuligpes were 147 (69.01%) and 46.4% of the patients were free of dysmenorrhea between 2 and 4 years after surgery. The disease stages were: rASM (I: 4.69%, II: 22.5%, III: 30.04%, IV: 42.7%) and AAGL (I: 4.69%, II: 14.55%, III: 16.43%, IV: 64.31%). Blood loss ranged from 10 to 700 ml, and the average surgical time was 177.5 minutes. The mean pain before and after surgery was 9.0 and 1.0, respectively, with an average reduction of 7.9 points on the VAS (p<0.001).
Conclusions: Laparoscopic peritonectomy is effective in the management of peritoneal endometriosis, with a 46.4% absence of dysmenorrhea at 2 years and an average decrease of 7.9 points in pain intensity.
Keywords: Endometriosis, laparoscopy, dysmenorrhea, recurrence.

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