Design: Cross-sectional

Setting: a Tertiary hospital in São Paulo

Patients or Participants: 100 women with endometriosis between 2022 and 2023.

Interventions: laparoscopic endometriosis surgery during the National Training Program for endometriosis.

Measurements and Main Results:: Data regarding the type of endometriosis surgery (simple and complex), demographics, and AAGL Staging were collected using the Redcap program. Chi-square tests, Fisher's Exact test, Mann-Whitney test, or Spearman correlation were applied, depending on the type of variable. Of the surgical procedures, 38% were for simple endometriosis and 62% for complex endometriosis with bowel involvement. The mean age of included women was 38.5 years (SD=5.7), ranging from 24.9 to 49.6 years old. Demographic variables, comorbidities, and number of pregnancies adjusted by age did not show statistically significant differences between surgical types (p>0.050). Among women who underwent complex surgery, 20% reported previous endometriosis surgery compared to 7.9% in the simple group (p=0.105). In the simple endometriosis group, most (50%) were Stage 1 and in complex group most (74.2%) were Stage 4 (p<0.001). The length of hospital stay was shorter (p<0.001) in women who underwent simple surgery [2 (1-4) days), compared to those undergoing complex surgery [4 (1-29) days]. Eighteen postoperative complications were reported, being 8 minor (3 in the simple group and 5 in the complex group; p=0.762) and 10 major (0 in the simple group and 10 in the complex group; p=0.01176). Re-operations due to rectovaginal fistula or anastomotic dehiscence were observed in 4% of cases, all from the complex endometriosis group (5.9% versus 0%).

Conclusion: The Endometriosis Training Program presented surgical outcomes similar to those reported in the literature. The group undergoing complex endometriosis surgery had higher AAGL staging and a higher rate of severe complications compared to simple endometriosis surgeries.