Comparison between laparotomy and operative laparoscopy in the treatment of moderate and severe stages of endometriosis.

A retrospective study was designed to compare the results of treatment of moderate and severe stages of endometriosis by laparotomy and by laparoscopy. Patients were divided into three groups: the first consisted of 42 patients treated by laparotomy followed immediately with danazol treatment for 6-9 months; the second, 44 patients treated by operative laparoscopy followed immediately with danazol treatment for 4-6 months; and the third, 62 patients treated by operative laparoscopy followed immediately with danazol treatment for 6-10 weeks. The cumulative pregnancy rate in the laparoscopy groups was better than that of the laparotomy group. Most patients who failed to conceive underwent a second-look laparoscopy for reevaluation. Residual endometriosis and associated adhesions were noticed least in the third group. It is concluded that operative laparoscopy could be efficiently used for the treatment of moderate or even severe endometriosis.