Chapron C, Dubuisson J B, Fernandez B, Dousset B
Service de gynécologie-obstétrique II, CHU Cochin Port-Royal, Paris.
Rev Prat. 1999 Feb 1;49(3):276-8.
The treatment of first intention for endometriosis must be surgery. In cases of infertility the surgical treatment of choice is laparoscopic surgery, maybe in conjunction with the medical treatment and possibly followed-up by a second-look. When there is pelvic pain, the treatment relies on complete exeresis of the endometriotic lesions. In this context, laparoscopic surgery is as efficient as laparotomy for dealing with ovarian endometriomas, deep endometriosis infiltrating the uterosacral ligaments, the rectovaginal septum and the bladder. However, in the majority of cases bowel endometriosis is still an indication to operate by laparotomy.
子宫内膜异位症的一期治疗必须是手术。对于不孕病例，首选的手术治疗是腹腔镜手术，可能结合药物治疗，并可能在术后进行二次探查。当出现盆腔疼痛时，治疗依赖于彻底切除子宫内膜异位病灶。在这种情况下，腹腔镜手术在处理卵巢子宫内膜异位囊肿、浸润子宫骶韧带、直肠阴道隔和膀胱的深部子宫内膜异位症方面与剖腹手术同样有效。然而，在大多数情况下，肠道子宫内膜异位症仍然是剖腹手术的指征。
