Risk factors for recurrence and re-recurrence of ovarian endometriomas after laparoscopic excision
Risk factors for recurrence and re-recurrence of ovarian endometriomas after laparoscopic excision
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DOI：
10.1111/j.1447-0756.2010.01409.x
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发表时间：
2011-06-01
影响因子：
1.6
通讯作者：
Yaegashi, Nobuo
中科院分区：
文献类型：
--
作者：
Hayasaka, Shinichi;Ugajin, Tomohisa;Yaegashi, Nobuo
目的：由于卵巢子宫内膜异位瘤在育龄妇女中经常被诊断出来，腹腔镜下子宫内膜异位瘤切除术是大多数病例的选择。然而，子宫内膜异位瘤即使在多次手术后也经常复发。我们研究的目的是确定子宫内膜异位瘤在第一次和第二次腹腔镜切除术后复发和再复发的危险因素。材料与方法：我们回顾性评估173例腹腔镜子宫内膜异位瘤切除术后至少随访一年的患者。分别对10个和8个因素进行评估，以评估其对复发和再复发风险的影响。采用单因素和Cox回归检验对影响因素进行分析。结果：总复发率为45.1%，再发复率为45.5%。1997年修订的美国生殖医学学会评分较高，与复发风险增加有关。只有术后妊娠与复发风险降低有关。从第一次手术到复发的短时间正常月经或促性腺激素释放激素类似物与较高的复发率相关。结论：较高的美国生殖医学学会评分是危险因素，术后妊娠对复发有保护作用。从首次手术到复发，月经正常时间短，未怀孕或使用促性腺激素释放激素类似物的患者复发风险高。
Aim:Since ovarian endometrioma is frequently diagnosed in women of reproductive age, laparoscopic excision of the endometrioma is performed for most cases. However, endometriomas frequently recurs even after repeated surgical procedures. The aim of our study is to identify risk factors for recurrence and re-recurrence of endometriomas after the first and second laparoscopic excision.Material & Methods:We retrospectively evaluated 173 patients who had a minimum of one year postoperative follow-up after the laparoscopic excision of endometriomas. Ten and eight factors were evaluated to assess their effect on the risk of recurrence and re-recurrence, respectively. Factors were analyzed using univariate and the Cox regression test.Results:The overall rate of recurrence and re-recurrence were 45.1% and 45.5%, respectively. A high revised American Society for Reproductive Medicine score (1997) was associated with an increased risk of recurrence. Only postoperative pregnancy was associated with a decreased risk of recurrence. Short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence were associated with higher rate of re-recurrence.Conclusions:A high revised American Society for Reproductive Medicine score was a risk factor, and postoperative pregnancy was protective against recurrence. The patient with short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence had a high risk of re-recurrence.