8740 Preparing for the Operating Room: What to Expect at Time of Surgery for Patients with History of Endometriomas

Abstract

<h3>Study Objective</h3> This study aims to examine if history or presence of endometriomas is an independent risk factor for adhesive disease, longer operative time, and higher blood loss in patients undergoing endometriosis surgery. <h3>Design</h3> Our study was a retrospective chart review which reviewed the endometriosis cases of two surgeons at our institution from March 2018 to March 2021. A report was generated using CPT codes billed for the surgeries performed. 11 CPT codes were used to ensure we captured all endometriosis cases. These codes included any procedure of the ovary, fallopian tube, excision of endometriosis, or laparoscopic appendectomy. Charts were then reviewed and included in the study if endometriosis was confirmed on pathology. Comparisons were made using Wilcoxon rank sum and Chi-Squared tests. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> N/A. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> The query resulted in 3,106 matches for the 2 surgeons using the 11 CPT codes queried with 1,120 individual surgical cases. Of these patients, 389 had endometriosis confirmed on pathology and were included in the analysis. We analyzed three outcome variables at time of surgery including presence of adhesions, case length, and blood loss in the setting of one risk factor, prior surgical or image history of endometrioma. There was a higher percentage of patients with a prior surgical or image history of endometrioma also having adhesions (76.47%), compared to those who did not (45.52%) (p<0.001). The median case length (372 min vs 221 min) and median blood loss (50cc vs 25cc) were both statistically significantly higher amongst patients with prior surgical or image history of endometrioma compared to those who did not. <h3>Conclusion</h3> Of patients undergoing surgery for endometriosis, those with endometriomas or a history of endometriomas had a higher rate of adhesions, longer case length, and greater blood loss compared to those who did not. This information will help improve surgical preparation, expectations, and counseling.