Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation
Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation
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DOI：
10.1016/j.ajog.2013.11.007
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发表时间：
2014-03-01
影响因子：
9.8
通讯作者：
Cho, Yeon Jean
中科院分区：
文献类型：
--
作者：
Kim, Mi-La;Kim, Joo Myoung;Cho, Yeon Jean
目的：我们旨在评估二线、保守的腹腔镜子宫内膜异位囊肿剜除术后子宫内膜异位囊肿的累积复发率，并分析影响子宫内膜异位囊肿复发的因素。 研究设计：2000年1月至2010年12月在3个妇科手术中心进行了一项多中心回顾性队列研究。之前选择了2次。所有患者的年龄均为 20 毫米。 结果：总共 183 名患者接受了 33.2 +/- 27.7 个月（范围 6-121 个月）的随访。 38 名（20.8%）患者在二线手术后出现复发，24 名（13.1%）患者接受了第三次手术。中位复发时间为 24 +/- 3.36 个月 (SEM)（范围为 3-72 个月）。二线手术后12、24、36和60个月时每位患者的累积复发率分别为7.7%、13.7%、21.3%和37.5%。经过多变量分析和协方差分析，子宫内膜异位瘤第三次复发的患者的修订后的美国生育协会评分和分期显着更高。结论：二线手术后卵巢子宫内膜异位瘤的累积复发率似乎与随访时间相关。二线手术中的严重子宫内膜异位症似乎是与高复发风险相关的一个因素。医生应谨慎对待这些患者的术后管理。
OBJECTIVE: We sought to evaluate the cumulative recurrence rate of endometrioma after a second-line, conservative, laparoscopic endometriotic cyst enucleation and to analyze the factors that influence the recurrence of endometrioma.STUDY DESIGN: A multicenter retrospective cohort study was performed at 3 gynecologic surgery centers from January 2000 through December 2010. Patients surgically treated by laparoscopic enucleation of endometriotic cysts on 2 previous occasions were selected. All patients were aged = 20 mm.RESULTS: In total, 183 patients were followed up for 33.2 +/- 27.7 months (range, 6-121 months). Thirty-eight (20.8%) patients experienced recurrence after the second-line surgery and 24 (13.1%) patients underwent a third surgery. The median time to recurrence was 24 +/- 3.36 months (SEM) (range, 3-72 months). The cumulative recurrence rates per patient at 12, 24, 36, and 60 months after the second-line surgery were 7.7%, 13.7%, 21.3%, and 37.5%, respectively. After multivariate analysis and analysis of covariance, the revised American Fertility Society score and stage were significantly higher in patients who experience a third recurrence of endometrioma.CONCLUSION: The cumulative recurrence rate of ovarian endometrioma after a second-line surgery appears to be correlated to the duration of follow-up. Severe endometriosis at the second-line surgery seems to be a factor associated with a high recurrence risk. Physicians should be cautious with regard to the postoperative management of these patients.