EFFECTIVENESS OF SURGICAL APPROACHES IN THE TREATMENT OF ADVANCED ENDOMETRIOSIS: A COMPARISON BETWEEN LAPAROSCOPIC TECHNIQUES AND RADICAL SURGERY IN THE REPRODUCTIVE CONTEXT

Abstract

Advanced endometriosis is a complex gynecological condition that often compromises both fertility and patients' quality of life. This study, through a systematic review, comparatively analyzed the effectiveness of conservative laparoscopic surgical approaches versus radical surgery in the treatment of deep endometriosis, with a focus on clinical and reproductive outcomes. The data show that laparoscopy offers advantages in terms of lower morbidity, preservation of reproductive organs, and improved fertility, especially when performed in specialized centers. On the other hand, radical surgery, although more invasive, demonstrates greater effectiveness in long-term pain relief and lower recurrence rates in refractory patients without reproductive desire. The choice of the ideal approach should consider the extent of the disease, the patient’s reproductive goals, and the surgical team's expertise. It is concluded that treatment should be individualized, prioritizing the balance between symptom control and preservation of reproductive function.