ESHRE guideline: endometriosis.
ESHRE guideline: endometriosis.
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DOI：
10.1093/hropen/hoac009
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发表时间：
2022
影响因子：
8.3
通讯作者：
ESHRE Endometriosis Guideline Group
中科院分区：
文献类型：
--
作者：
Becker CM;Bokor A;Heikinheimo O;Horne A;Jansen F;Kiesel L;King K;Kvaskoff M;Nap A;Petersen K;Saridogan E;Tomassetti C;van Hanegem N;Vulliemoz N;Vermeulen N;ESHRE Endometriosis Guideline Group
应如何根据已发表文献中的最佳可用证据来诊断和治疗子宫内膜异位症？目前的指南提供了 109 条建议，涉及诊断、疼痛和不孕症的治疗、疾病复发的管理、无症状或盆腔外疾病、青少年和绝经后妇女的子宫内膜异位症、预防以及与癌症的关系。子宫内膜异位症是一种慢性疾病，不仅会出现病变，还会出现体征和症状。最重要的症状包括疼痛和不孕。该指南是根据 ESHRE 指南制定的结构化方法制定的。专家组提出关键问题后，进行文献检索和评估。截至 2020 年 12 月 1 日发表的英文论文均纳入文献综述。根据收集到的证据，在专家小组内制定和讨论建议，然后提交给核心指南制定小组 (GDG)，直至达成共识。草案定稿后，组织了利益相关者审查。最终版本得到了 GDG 和 ESHRE 执行委员会的批准。本指南旨在帮助临床医生为患有子宫内膜异位症的女性提供最佳护理。尽管研究主要集中在育龄妇女，但该指南也涉及青少年和绝经后妇女的子宫内膜异位症。该指南概述了子宫内膜异位症的诊断过程，这对腹腔镜检查和组织学作为金标准诊断测试提出了挑战。治疗子宫内膜异位症相关疼痛症状的选择包括镇痛药、药物治疗和手术。还讨论了非药物治疗。对于子宫内膜异位症相关的不孕症的治疗，手术治疗和/或医学辅助生殖是可行的。虽然大多数最近的研究证实了之前的 ESHRE 建议，但有五个主题需要对建议进行重大修改，并且预计临床实践也会发生变化。该指南描述了不同的管理方案，但根据现有证据，无法就最合适的治疗方案制定明确的建议。此外，对于特定的临床问题，例如无症状子宫内膜异位症或盆腔外子宫内膜异位症，证据太缺乏，无法提出基于证据的建议。该指南根据目前可用的最佳证据，为临床医生提供有关子宫内膜异位症护理最佳实践的明确建议。此外，还提供了一系列研究建议，以促进子宫内膜异位症的进一步研究。该指南由 ESHRE 制定和资助，涵盖与指南会议、文献检索和指南传播相关的费用。指导小组成员没有收到付款。 C.M.B.报告拜耳医疗保健和欧盟委员会的资助；参与 ObsEva（数据安全监测小组）和 Myovant（科学顾问小组）的数据安全监测委员会或顾问委员会。 A.B.报告来自 FEMaLE 执行委员会成员的拨款和欧盟委员会 Horizon 2020 拨款；爱惜康内科手术、美敦力的咨询费； Ethicon 的讲座酬金；以及 Gedeon Richter 对出席会议的支持； A.H. 报告了来自 MRC、NIHR、CSO、Roche Diagnostics、Astra Zeneca、Ferring 的资助；罗氏诊断、Nordic Pharma、Chugai 和 Benevolent Al Bio Limited 的咨询费均支付给该机构；血清子宫内膜异位症生物标志物正在申请专利；他还是 STOP-OHSS 和 CERM 试验 TSC 的主席。哦。报告来自 Gedeon Richter 和拜耳公司的咨询费和演讲费；支持参加 Gedeon-Richter 的会议，并在芬兰妇产科协会和北欧妇产科协会联合会中担任领导职务。 L.K.报告来自 Gedeon Richter、阿斯利康、诺华、Dr KADE/Besins、Palleos Healthcare、罗氏、Mithra 的咨询费； Gedeon Richter、阿斯利康、诺华、Dr KADE/Besins、Palleos Healthcare、罗氏、Mithra 的讲座酬金；支持参加 Gedeon Richter、阿斯利康、诺华、Dr KADE/Besins、Palleos Healthcare、罗氏、Mithra 的会议；他还在德国妇科内分泌学会 (DGGEF) 中担任领导职务。 M.K.报告获得法国医学研究基金会 (FRM)、澳大利亚卫生部、医学研究未来基金和法国国家癌症研究所的资助；支持欧洲妇科内窥镜协会 (ESGE)、欧洲子宫内膜异位症大会 (EEC) 和 ESHRE 出席会议；她是 FEMaLe 项目（利用机器学习查找子宫内膜异位症）的顾问委员会成员、法国子宫内膜异位症研究基金会的科学委员会主席以及 CompPaRe-子宫内膜异位症队列的科学委员会主席。一个。报告来自 Merck SA 和 Ferring 的资助； Merck SA 和 Ferring 收取演讲费用；默克公司对出席会议的支持；参与 Nordic Pharma 和 Merck SA 的数据安全监控委员会或咨询委员会；她还是荷兰子宫内膜异位症协会医学咨询委员会（患者权益团体）的董事会成员以及世界子宫内膜异位症协会的执行委员会成员。 E.S.报告来自英国国家健康研究所、Rosetrees Trust、Barts 和伦敦慈善机构的资助； De Gruyter（书籍编辑）的版税； Hologic 的咨询费； Hologic、Johnson & Johnson、Medtronic、Intuitive、Olympus 和 Karl Storz 的演讲费用；参与药品和保健品监管机构 (MHRA) 的女性健康药品专家咨询小组；他还是世界子宫内膜异位症协会的大使。 CT报告默克公司的资助； Gedeon Richter、Nordic Pharma 和 Merck SA 的咨询费； Merck SA 的演讲费用全部支付给该机构；以及 Ferring、Gedeon Richter 和 Merck SA 对出席会议的支持。其他作者没有需要声明的利益冲突。本指南代表了 ESHRE 的观点，这些观点是在仔细考虑了准备时可用的科学证据后得出的。在某些方面缺乏科学证据的情况下，相关 ESHRE 利益相关者之间已达成共识。 遵守这些临床实践指南并不能保证成功或特定的结果，也不能建立护理标准。临床实践指南并不能取代对每个个体表现应用临床判断的需要，也不能取代基于地点和设施类型的变化。 ESHRE 对临床实践指南不做任何明示或暗示的保证，并特别排除对适销性和特定用途或目的的适用性的任何保证（完整免责声明请参见 www.eshre.eu/guidelines）。
How should endometriosis be diagnosed and managed based on the best available evidence from published literature? The current guideline provides 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. Endometriosis is a chronic condition with a plethora of presentations in terms of not only the occurrence of lesions, but also the presence of signs and symptoms. The most important symptoms include pain and infertility. The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 1 December 2020 and written in English were included in the literature review. Based on the collected evidence, recommendations were formulated and discussed within specialist subgroups and then presented to the core guideline development group (GDG) until consensus was reached. A stakeholder review was organized after finalization of the draft. The final version was approved by the GDG and the ESHRE Executive Committee. This guideline aims to help clinicians to apply best care for women with endometriosis. Although studies mostly focus on women of reproductive age, the guideline also addresses endometriosis in adolescents and postmenopausal women. The guideline outlines the diagnostic process for endometriosis, which challenges laparoscopy and histology as gold standard diagnostic tests. The options for treatment of endometriosis-associated pain symptoms include analgesics, medical treatments and surgery. Non-pharmacological treatments are also discussed. For management of endometriosis-associated infertility, surgical treatment and/or medically assisted reproduction are feasible. While most of the more recent studies confirm previous ESHRE recommendations, there are five topics in which significant changes to recommendations were required and changes in clinical practice are to be expected. The guideline describes different management options but, based on existing evidence, no firm recommendations could be formulated on the most appropriate treatments. Also, for specific clinical issues, such as asymptomatic endometriosis or extrapelvic endometriosis, the evidence is too scarce to make evidence-based recommendations. The guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. In addition, a list of research recommendations is provided to stimulate further studies in endometriosis. The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the dissemination of the guideline. The guideline group members did not receive payments. C.M.B. reports grants from Bayer Healthcare and the European Commission; Participation on a Data Safety Monitoring Board or Advisory Board with ObsEva (Data Safety Monitoring Group) and Myovant (Scientific Advisory Group). A.B. reports grants from FEMaLE executive board member and European Commission Horizon 2020 grant; consulting fees from Ethicon Endo Surgery, Medtronic; honoraria for lectures from Ethicon; and support for meeting attendance from Gedeon Richter; A.H. reports grants from MRC, NIHR, CSO, Roche Diagnostics, Astra Zeneca, Ferring; Consulting fees from Roche Diagnostics, Nordic Pharma, Chugai and Benevolent Al Bio Limited all paid to the institution; a pending patent on Serum endometriosis biomarker; he is also Chair of TSC for STOP-OHSS and CERM trials. O.H. reports consulting fees and speaker’s fees from Gedeon Richter and Bayer AG; support for attending meetings from Gedeon-Richter, and leadership roles at the Finnish Society for Obstetrics and Gynecology and the Nordic federation of the societies of obstetrics and gynecology. L.K. reports consulting fees from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; honoraria for lectures from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; support for attending meetings from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; he also has a leadership role in the German Society of Gynecological Endocrinology (DGGEF). M.K. reports grants from French Foundation for Medical Research (FRM), Australian Ministry of Health, Medical Research Future Fund and French National Cancer Institute; support for meeting attendance from European Society for Gynaecological Endoscopy (ESGE), European Congress on Endometriosis (EEC) and ESHRE; She is an advisory Board Member, FEMaLe Project (Finding Endometriosis Using Machine Learning), Scientific Committee Chair for the French Foundation for Research on Endometriosis and Scientific Committee Chair for the ComPaRe-Endometriosis cohort. A.N. reports grants from Merck SA and Ferring; speaker fees from Merck SA and Ferring; support for meeting attendance from Merck SA; Participation on a Data Safety Monitoring Board or Advisory Board with Nordic Pharma and Merck SA; she also is a board member of medical advisory board, Endometriosis Society, the Netherlands (patients advocacy group) and an executive board member of the World Endometriosis Society. E.S. reports grants from National Institute for Health Research UK, Rosetrees Trust, Barts and the London Charity; Royalties from De Gruyter (book editor); consulting fees from Hologic; speakers fees from Hologic, Johnson & Johnson, Medtronic, Intuitive, Olympus and Karl Storz; Participation in the Medicines for Women’s Health Expert Advisory Group with Medicines and Healthcare Products Regulatory Agency (MHRA); he is also Ambassador for the World Endometriosis Society. C.T. reports grants from Merck SA; Consulting fees from Gedeon Richter, Nordic Pharma and Merck SA; speaker fees from Merck SA, all paid to the institution; and support for meeting attendance from Ferring, Gedeon Richter and Merck SA. The other authors have no conflicts of interest to declare. This guideline represents the views of ESHRE, which were achieved after careful consideration of the scientific evidence available at the time of preparation. In the absence of scientific evidence on certain aspects, a consensus between the relevant ESHRE stakeholders has been obtained. Adherence to these clinical practice guidelines does not guarantee a successful or specific outcome, nor does it establish a standard of care. Clinical practice guidelines do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. ESHRE makes no warranty, express or implied, regarding the clinical practice guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose (Full disclaimer available at www.eshre.eu/guidelines.).
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DOI：
10.1111/j.1471-0528.2008.01878.x
发表时间：
2008-10-01
影响因子：
5.8
作者：
Ballard, K. D.;Seaman, H. E.;Wright, J. T.
通讯作者：
Wright, J. T.
影响因子：
4.1
作者：
Breteau, Pauline;Chanavaz-Lacheray, Isabella;Roman, Horace
通讯作者：
Roman, Horace
影响因子：
6.7
作者：
Bazot, Marc;Lafont, Clarisse;Darai, Emile
通讯作者：
Darai, Emile
影响因子：
9.8
作者：
Busacca, Mauro;Riparini, Jennifer;Candiani, Massimo
通讯作者：
Candiani, Massimo
影响因子：
3.7
作者：
Butt, Sedrah Arif;Lidegaardi, Ojvind;Morch, Lina Steinrud
通讯作者：
Morch, Lina Steinrud