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Bertocchi E, Meoli F, Masini G, Ceccaroni M, Bruni F, Roviglione G, Rossini R, Barugola G, Mazzi C, Ruffo G. Early Quality of Life Assessment After Segmental Colorectal Resection for Deep Infiltrating Endometriosis. J Minim Invasive Gynecol 2024; 31:221-226. [PMID: 38114018 DOI: 10.1016/j.jmig.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
STUDY OBJECTIVE Endometriosis is a benign condition afflicting women of reproductive age that significantly impacts their quality of life (QoL). Given its debilitating symptoms and prevalence, it is essential to define its proper management. In this study, we have assessed patient-reported outcomes among women having undergone segmental colorectal resection for deep infiltrating endometriosis. Any correlation between preoperative nutritional status and overall postoperative complications has also been analyzed. STUDY DESIGN Prospective observational study. SETTING Public medical center. PATIENTS One hundred forty consecutive patients that had undergone segmental colorectal resection for DIE between November 2020 and October 2021 at IRCCS Sacro Cuore Don Calabria Hospital of Negrar of Valpolicella (Verona, Italy). INTERVENTIONS Patient-reported outcomes were measured using data collected from the MD Anderson Symptom Inventory for gastrointestinal surgery patients and Euro-QoL Group EQ-5D-5L (EQ-5Q-5L) questionnaires, which were administered preoperatively (T0), at discharge (T1) and at 4 to 6 weeks after surgery (T2). Nutritional status was examined through the Mini Nutritional Assessment Short form and Prognostic Nutritional Index. MEASUREMENTS AND MAIN RESULTS A significant improvement in the EQ-5Q-5L and MDASI-GI scores was noted between T0 and T2 (p <. 001 and p <. 001, respectively.) No statistically significant differences were found in scores at T2 between patients who had experienced postoperative complications and those who had not. No statistically significant association was observed between the presence of malnutrition and overall postoperative complications and their severity. CONCLUSION This study confirms, through patient-reported outcomes, the pivotal role of surgery in improving the QoL at 4 to 6 weeks of women affected by endometriosis who have previously been unresponsive to medical therapy.
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Affiliation(s)
- Elisa Bertocchi
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo).
| | - Francesca Meoli
- Department of General Surgery and Surgical Specialities (Dr. Meoli), Sapienza University of Rome, Rome, Italy
| | - Gaia Masini
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Francesco Bruni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Roberto Rossini
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Giuliano Barugola
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Cristina Mazzi
- Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Clinical Research Unit, IRCCS Ospedale Sacro Cuore Don Calabria (Dr. Mazzi), Negrar di Valpolicella, Verona
| | - Giacomo Ruffo
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
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Xholli A, Londero AP, Cavalli E, Scovazzi U, Ferraro MF, Vacca I, Schiaffino MG, Oppedisano F, Sirito G, Molinari F, Cagnacci A. The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:69-76. [PMID: 36746396 DOI: 10.1055/a-2028-8214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVES This study aimed to evaluate elastography features of deep infiltrating endometriosis (DIE), and to define whether this technique may discriminate lesions from surrounding non-endometriotic tissue. METHODS This was an exploratory observational study on women affected by DIE treated in a third-level academic hospital gynaecology outpatient facility between 2020 and 2021. Strain elastography (SE) was conducted via transvaginal probe. Tissue deformation of DIE and surrounding tissue was expressed as percentage tissue deformation or as subjective colour score (CS; from blue=stiff to red=soft, assigned numerical values from 0 to 3). Ratios of normal tissue/DIE were compared to ratio of normal tissue/stiffer normal tissue area. RESULTS Evaluations were performed on 46 DIE nodules and surrounding tissue of the uterosacral ligaments (n=21), parametrium (n=7), rectum (n=14), and recto-vaginal septum (n =4). Irrespective of location, DIE strain ratio (3.09, IQR 2.38-4.14 vs. 1.25, IQR 1.11-1.48; p<0.001) and CS ratio (4.62, IQR 3.83-6.94 vs. 1.13, IQR 1.06-1.29; p<0.001) was significantly higher than that of normal tissue. ROC AUC of CS ratio was higher than ROC AUC of strain ratio (99.76%, CI.95 99.26-100% vs. 91.35%, CI.95 85.23-97.47%; p=0.007), and best ROC threshold for CS ratio was 1.82, with a sensitivity of 97.83% (CI.95 93.48-100%) and a specificity of 100% (CI.95 100-100%). CONCLUSIONS Both strain and CS ratios accurately distinguish DIE nodules at various locations. Applications of elastography in improving the diagnosis DIE, in distinguishing different DIE lesions and in monitoring DIE evolution can be envisioned and are worthy of further evaluation.
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Affiliation(s)
- Anjeza Xholli
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Elena Cavalli
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Umberto Scovazzi
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Mattia Francesco Ferraro
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ilaria Vacca
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maria Giulia Schiaffino
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesca Oppedisano
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Giorgio Sirito
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Filippo Molinari
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Angelo Cagnacci
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- DINOGMI, University of Genoa, Genova, Italy
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Villa NAC, Benetti-Pinto CL, Yela DA. Evaluation of Bowel Function of Women with Colorectal Endometriosis: a Cross-Sectional Study. Reprod Sci 2023; 30:3590-3596. [PMID: 37607988 DOI: 10.1007/s43032-023-01324-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
The objective was to evaluate bowel function in women with colorectal endometriosis according to treatment type. Cross-sectional study, carried out with 141 women with endometriosis, followed by the University of Campinas from May 2020 to April 2021. Women were divided into 3 groups according to the kind of treatment: 16 women with conservative surgery, 35 women with radical surgery treatment, and 90 women with clinical treatment. The clinical and sociodemographic characteristics of these women were evaluated. To access bowel outcome, we used the following questionnaires: the Bristol Stool Scale, the Bowel Function in the Community, the Gastrointestinal Quality of Life Index (GIQLI), and the Pelvic Floor Distress Inventory (PFDI-20). The mean treatment time was 32.24 ± 29.37 months. The women of the three groups had similar gastrointestinal quality of life index scores (p = 0.27) and pelvic floor distress inventory scores (p = 0.23). Women in the radical surgery group had a higher frequency of evacuatory effort and change in posture to evacuate (p = 0.01 and 0.009, respectively) than did those in the other groups. Women with constipation had worse quality of life and more pain than those without constipation. In conclusion, women with endometriosis treated with radical surgery (segmental resection) had a higher frequency of constipation. In addition, women with endometriosis and constipation had a worse quality of life and higher pain scores compared to those without constipation.
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Affiliation(s)
- Nara Abe Cairo Villa
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Alexander Fleming Street 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil
| | - Cristina Laguna Benetti-Pinto
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Alexander Fleming Street 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil
| | - Daniela Angerame Yela
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Alexander Fleming Street 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil.
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Christiansen A, Connelly TM, Lincango EP, Falcone T, King C, Kho R, Russo ML, Jia X, Valente M, Kessler H. Endometriosis with colonic and rectal involvement: surgical approach and outcomes in 142 patients. Langenbecks Arch Surg 2023; 408:385. [PMID: 37773225 DOI: 10.1007/s00423-023-03095-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Endometriosis involving the colon and/or rectum (CRE) is operatively managed using various methods. We aimed to determine if a more limited excision is associated with 30-day complications, symptom improvement, and/or recurrence. METHODS This is a retrospective review of consecutive cases of patients who underwent surgical management of CRE between 2010 and 2018. Primary outcomes were the associations between risk factors and symptom improvement, 30-day complications, and time to recurrence. Multivariable logistic regression assessed the independent risk factors. RESULTS Of 2681 endometriosis cases, 142 [5.3% of total, mean age 35.4 (31.0; 39.0) years, 73.9% stage IV] underwent CRE excision (superficial partial = 66.9%, segmental = 27.5%, full thickness = 1.41%). Minor complications (14.8%) were associated with blood loss [150 (112; 288) vs. 100 (50.0; 200) mls, p = 0.046], Sigmoid involvement [45.5% vs. 12.2%, HR 5.89 (1.4; 22.5), p = 0.01], stoma formation [52.6% vs. 8.9%, HR 10.9 (3.65; 34.1), p < 0.001], and segmental resection [38.5% vs. 5.8%, HR 9.75 (3.54; 30.4), p < 0.001]. Superficial, partial-thickness resections were associated with decreased risk [(4.2% vs. 36.2%), HR 0.08 (0.02; 0.24), p < 0.001]. Factors associated with major complications (8.5%) were blood loss [250 (100; 400) vs. 100 (50.0; 200) mls, p = 0.03], open surgery [31.6% vs. 4.9%, HR 8.74 (2.36; 32.9), p = 0.001], stoma formation [42% vs. 3.3%, HR 20.3 (5.41; 90.0), p < 0.001], and segmental colectomy [28.2% vs. 0.9%, HR 34.6 (6.25; 876), p < 0.001]. Partial-thickness resection was associated with decreased risk ([.05% vs. 23.4%, HR 8.74 (2.36; 32.9), p < 0.001]. 19.1% experienced recurrence. Open surgery [5.2% vs. 21.3%, HR 0.14 (0.02; 1.05), p = 0.027] and superficial partial thickness excision [23.4% vs. 10.6%, HR 2.86 (1.08; 7.59), p = 0.027] were associated. Segmental resection was associated with decreased recurrence risk [7.6% vs. 23.5%, HR 0.27 (0.08; 0.91), p = 0.024]. CONCLUSION Limiting resection to partial-thickness or full-thickness disc excision compared to bowel resection may improve complications but increase recurrence risk.
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Affiliation(s)
| | - Tara M Connelly
- Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Eddy P Lincango
- Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Tommaso Falcone
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Cara King
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Rosanne Kho
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Miguel Luna Russo
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Xue Jia
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Michael Valente
- Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Hermann Kessler
- Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Fuchs KH, Musial F, Retzbach L, Hann A, Meining A. Quality of life in benign colorectal disease-a review of the assessment with the Gastrointestinal Quality of Life Index (GIQLI). Int J Colorectal Dis 2023; 38:172. [PMID: 37338676 PMCID: PMC10282040 DOI: 10.1007/s00384-023-04473-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND PURPOSE The Gastrointestinal Quality of Life Index (GIQLI) is an instrument for the assessment of quality of life (QOL) in diseases of the upper and lower GI tract, which is validated in several languages around the world. The purpose of this literature review is the assessment of the GIQLI in patients with benign colorectal diseases. Reports on GIQLI data are collected from several institutions, countries, and different cultures which allows for comparisons, which are lacking in literature. METHODS The GIQL Index uses 36 items around 5 dimensions (gastrointestinal symptoms (19 items), emotional dimension (5 items), physical dimension (7 items), social dimension (4 items), and therapeutic influences (1 item). The literature search was performed on the GIQLI and colorectal disease, using reports in PubMed. Data are presented descriptively as GIQL Index points as well as a reduction from 100% maximum possible index points (max 144 index points = highest quality of life). RESULTS The GIQLI was found in 122 reports concerning benign colorectal diseases, of which 27 were finally selected for detailed analysis. From these 27 studies, information on 5664 patients (4046 female versus 1178 male) was recorded and summarized. The median age was 52 years (range 29-74.7). The median GIQLI of all studies concerning benign colorectal disease was 88 index points (range 56.2-113). Benign colorectal disease causes a severe reduction in QOL for patients down to 61% of the maximum. CONCLUSIONS Benign colorectal diseases cause substantial reductions in the patient's QOL, well documented by GIQLI, which allows a comparison QOL with other published cohorts.
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Affiliation(s)
- Karl-Hermann Fuchs
- Laboratory for Interventional and Experimental Endoscopy (InExEn), Gastroenterology, University of Würzburg, Auvera-Haus, Grombühlstr.12, 97080, Würzburg, Germany.
| | - Frauke Musial
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Laura Retzbach
- Laboratory for Interventional and Experimental Endoscopy (InExEn), Gastroenterology, University of Würzburg, Auvera-Haus, Grombühlstr.12, 97080, Würzburg, Germany
| | - Alexander Hann
- Laboratory for Interventional and Experimental Endoscopy (InExEn), Gastroenterology, University of Würzburg, Auvera-Haus, Grombühlstr.12, 97080, Würzburg, Germany
| | - Alexander Meining
- Laboratory for Interventional and Experimental Endoscopy (InExEn), Gastroenterology, University of Würzburg, Auvera-Haus, Grombühlstr.12, 97080, Würzburg, Germany
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Wu S, Wang X, Liu H, Zheng W. Efficacy of cognitive behavioral therapy after the surgical treatment of women with endometriosis: A preliminary case-control study. Medicine (Baltimore) 2022; 101:e32433. [PMID: 36595829 PMCID: PMC9794269 DOI: 10.1097/md.0000000000032433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Regardless of unique status or symptoms, any woman with endometriosis is at risk of developing mental health issues such as anxiety and depression. Cognitive behavioral therapy (CBT) is an effective psychological treatment for depression, anxiety, and stress. The objectives of the study were to see whether usual care combined with CBT improves depression, anxiety, and stress in patients after surgery for endometriosis as compared to usual care alone. METHODS Patients aged 18 to 50 years old with endometriosis who were scheduled for surgery were received usual care (Chinese martial arts) with CBT (1 pre-surgery and 6 post-surgery CBT sessions; Case or Intervention group, n = 48) or usual care only (Control group, n = 48). The demographic characteristics questionnaire was given to all individuals. Depression, anxiety, and stress were evaluated at baseline (within 24 hours after admission to the hospital) and postintervention (immediately before discharged) in both groups using the Chinese short version of Depression Anxiety and Stress scale (DASS-21). RESULTS At postintervention DASS-21 scores for depression, anxiety, and stress of the case group and the control group were decreased as compared to baseline (P < .0001 for all). At postintervention DASS-21 score for anxiety of the case group was decreased compared to the control group (P = .0091). Usual care plus CBT significantly increased the number of females with no symptoms of depression as compared to baseline at postintervention(s) (P = .0356). At postintervention(s), there was no female with extremely severe depression in both groups. Usual care plus CBT significantly decreased the number of females with symptoms of extremely severe anxiety as compared to baseline at postintervention(s) (P = .035). Unlike the control group, in the case group, there were no females with extremely severe stress at postintervention. CONCLUSIONS females with endometriosis who had surgery reported high levels of depression, anxiety, and stress at the time of hospital admission. Patients with endometriosis can benefit from CBT.
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Affiliation(s)
- Shanshan Wu
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xia Wang
- Cancer department of traditional Chinese medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu Sichuan, China
| | - Heng Liu
- Department of Obstetrics and Gynecology, the General Hospital of Western Theater Command PLA, Chengdu, Sichuan, China
| | - Wei Zheng
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- *Correspondence: Wei Zheng, Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan 610041, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China (e-mail: )
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Transvaginal Ultrasound vs. Magnetic Resonance Imaging (MRI) Value in Endometriosis Diagnosis. Diagnostics (Basel) 2022; 12:diagnostics12071767. [PMID: 35885670 PMCID: PMC9315729 DOI: 10.3390/diagnostics12071767] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/24/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Endometriosis is a widespread gynecological condition that causes chronic pelvic discomfort, dysmenorrhea, infertility, and impaired quality of life in women of reproductive age. Clinical examination, transvaginal ultrasonography (TVS), and magnetic resonance imaging (MRI) are significant preoperative non-invasive diagnosis procedures for the accurate assessment of endometriosis. Although TVS is used as the primary line for diagnosis, MRI is commonly utilized to achieve a better anatomical overview of the entire pelvic organs. The aim of this systematic review article is to thoroughly summarize the research on various endometriosis diagnosis methods that are less invasive. (2) Methods: To find relevant studies, we examined electronic databases, such as MEDLINE/PubMed, Cochrane, and Google Scholar, choosing 70 papers as references. (3) Results: The findings indicate that various approaches can contribute to diagnosis in different ways, depending on the type of endometriosis. For patients suspected of having deep pelvic endometriosis, transvaginal sonography should be the first line of diagnosis. Endometriosis cysts are better diagnosed with TVS, whereas torus, uterosacral ligaments, intestine, and bladder endometriosis lesions are best diagnosed using MRI. When it comes to detecting intestine or rectal nodules, as well as rectovaginal septum nodules, MRI should be the imaging tool of choice. (4) Conclusions: When diagnosing DE (deep infiltrative endometriosis), the examiner’s experience is the most important criterion to consider. In the diagnosis of endometriosis, expert-guided TVS is more accurate than routine pelvic ultrasound, especially in the deep infiltrative form. For optimal treatment and surgical planning, accurate preoperative deep infiltrative endometriosis diagnosis is essential, especially because it requires a multidisciplinary approach.
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Namazov A, Kathurusinghe S, Mehdi E, Merlot B, Prosszer M, Tuech JJ, Marpeau L, Roman H. Evolution of bowel complaints after laparoscopy endometriosis surgery: a 1497 women comparative study: Author's reply. J Minim Invasive Gynecol 2022; 29:448-449. [PMID: 34995775 DOI: 10.1016/j.jmig.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Ahmet Namazov
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel; Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel
| | | | - Elnur Mehdi
- Azerbaijan National Center of Oncology, Baku, Azerbaijan
| | - Benjamin Merlot
- Endometriosis Center, Clinique Tivoli-Ducos, Bordeaux, France
| | - Maria Prosszer
- Endometriosis Center, Clinique Tivoli-Ducos, Bordeaux, France
| | - Jean Jacques Tuech
- Department of Digestive Surgery, Rouen University Hospital, F-76000 Rouen, France
| | - Loic Marpeau
- Department of Gynecology and Obstetrics, Rouen University Hospital, F-76000 Rouen, France
| | - Horace Roman
- Endometriosis Center, Clinique Tivoli-Ducos, Bordeaux, France; Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark.
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