INCIDENCE OF SYMPTOM RECURRENCE AFTER HYSTERECTOMY FOR ENDOMETRIOSIS
INCIDENCE OF SYMPTOM RECURRENCE AFTER HYSTERECTOMY FOR ENDOMETRIOSIS
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DOI：
10.1016/s0015-0282(16)57899-6
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发表时间：
1995-11-01
影响因子：
6.7
通讯作者：
GOODMAN, SB
中科院分区：
文献类型：
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作者：
NAMNOUM, AB;GEHLBACH, DL;GOODMAN, SB
目的：为了确定子宫切除术保留卵巢治疗子宫内膜异位症后症状复发和/或再次手术的相对风险，设计：对子宫内膜异位症患者进行子宫切除术保留或不保留卵巢的历史前瞻性研究。计算机检索确定了138名妇女谁接受子宫切除术的诊断子宫内膜异位症在约翰霍普金斯医院从1979年至1991年，随访信息是从医疗记录，门诊图表，和电话调查。结果：29名妇女进行了子宫切除术，保留了一些卵巢组织; 109名妇女切除了所有卵巢组织。在保留卵巢的患者中，29例中有18例（62%）复发性疼痛，29例中有9例（31%）需要再次手术。在没有保留卵巢的患者中，109例中有11例（10%）有复发症状，109例中有4例（3.7%）需要再次手术。保留卵巢与疼痛复发的相对风险为6.1在考克斯比例风险模型中，与卵巢切除术患者相比，保留卵巢患者再次手术的相对风险为8.1（95% CI 2.1至31.3）。与因子宫内膜异位症行卵巢切除术的妇女相比，接受保留卵巢子宫切除术的患者发生复发性疼痛的风险是接受保留卵巢子宫切除术的患者的6.1倍，再次手术
Objectives: To determine the relative risk of symptom recurrence and/or reoperation after hysterectomy with ovarian preservation for the treatment of endometriosis,Design: Historical prospective study of patients with endometriosis who underwent hysterectomy with or without ovarian preservation.Patients: One hundred thirty-eight women who underwent hysterectomy with the diagnosis of endometriosis.Methods: A computer search identified 138 women who underwent hysterectomy with the diagnosis of endometriosis at Johns Hopkins Hospital from 1979 to 1991, Follow-up information was obtained from medical records, outpatient charts, and telephone surveys.Results: Twenty-nine women had hysterectomy with some ovarian tissue preserved; 109 had all ovarian tissue removed. Of those with ovarian preservation, 18 of 29 (62%) had recurrent pain and 9 of 29 (31%) required reoperation. Of those who had no ovarian preservation, 11 of 109 (10%) had recurrent symptoms and 4 of 109 (3.7%) required reoperation. Ovarian conservation was associated with a relative risk for pain recurrence of 6.1 (95% confidence interval [CI] 2.5 to 14.6) compared with patients with oophorectomy in a Cox proportional hazards model, The relative risk for reoperation in patients with ovarian conservation was 8.1 (95% CI 2.1 to 31.3).Conclusion: Compared with women who had oophorectomy for endometriosis, patients who underwent hysterectomy with ovarian conservation had 6.1 times greater risk of developing recurrent pain and 8.1 times greater risk of reoperation.