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[子宫外子宫内膜异位症是否局限于妇科领域?对普通外科单元经验的批判性综述]

[Is extrauterine endometriosis confined to the gynecological sphere? A critical review of the experience in a general surgery unit].

作者信息

De Falco M, Ragusa M, Oliva G, Miranda A, Parmeggiani D, Sperlongano P, Accardo M, Calzolari F, Misso C, Monacelli M, Avenia N

机构信息

Dipartimento di Scienze Anestesiologiche, Seonda Università degli Studi di Napoli.

出版信息

G Chir. 2007 Mar;28(3):83-92.

Abstract

Extrauterine or external endometriosis (e.e.) describes ectopic localization of functional endometrial tissue, a finding whose incidence is increasing due to the diffusion of laparoscopic procedures. The clinical presentation of such disease is often non-specific, even in those cases with a definite surgical indication, depending on the site and pathology of the lesions. Surgical planning is therefore difficult at times, specifically regarding the extent of resection in patients--as young women--willing to maintain fertility. The Authors report on 7 cases observed in their own experience (inguinal endometriosis--1 case, umbilical endometriosis--1 case, abdominal wall endometriosis--3 cases, intestinal endometriosis--1 case, diaphragmatic endometriosis associated with pneumothorax--1 case), representing the wide range of clinical settings related to e.e. Based on literature data, an analysis of clinical and diagnostic issues is carried out. Specifically, the problems related to extent of surgical resection in multifocal cases, possible malignant degeneration and localization on abdominal wall scars are discussed.

摘要

子宫外或外在性子宫内膜异位症(e.e.)是指功能性子宫内膜组织的异位定位,由于腹腔镜手术的普及,这一发现的发生率正在上升。这种疾病的临床表现通常不具有特异性,即使在那些有明确手术指征的病例中也是如此,这取决于病变的部位和病理情况。因此,手术规划有时会很困难,特别是对于那些希望保留生育能力的年轻女性患者,确定切除范围尤为棘手。作者报告了他们自己经验中观察到的7例病例(腹股沟子宫内膜异位症——1例,脐部子宫内膜异位症——1例,腹壁子宫内膜异位症——3例,肠道子宫内膜异位症——1例,与气胸相关的膈肌子宫内膜异位症——1例),这些病例代表了与子宫外或外在性子宫内膜异位症相关的广泛临床情况。基于文献数据,对临床和诊断问题进行了分析。具体而言,讨论了多灶性病例中手术切除范围、可能的恶性变以及腹壁瘢痕定位等相关问题。

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