Candiani G B, Vercellini P, Fedele L, Bianchi S, Vendola N, Candiani M
Department of Obstetrics and Gynecology L. Mangiagalli, University of Milano School of Medicine, Italy.
Obstet Gynecol Surv. 1991 Jul;46(7):490-8. doi: 10.1097/00006254-199107000-00029.
Conservative surgery for severe endometriosis in infertile women is one of the most challenging situations for the pelvic surgeon. The second half of the 1980s saw an increase in the supporters of laparoscopic treatment even for more extensive disease. Two opposing factions were thus created: traditional gynecologic surgeons who accuse endoscopists of imprudence and technical inadequacy and enthusiastic supporters of operative laparoscopy who consider laparotomy obsolete and its associated morbidity needlessly high for the patient and health service. In the present review of the literature data we analyze laparotomy and laparoscopy techniques and compare the postoperative results in terms of reproductive success in an attempt to clarify whether conservative endoscopic treatment of severe endometriosis is only an inappropriate proposal with no future or whether, due to its efficacy, it will eventually limit interventions via laparotomy to exceptional circumstances.
对于盆腔外科医生而言，为不孕女性进行重度子宫内膜异位症的保守性手术是最具挑战性的情况之一。20世纪80年代后半期，即使对于更广泛的疾病，腹腔镜治疗的支持者也有所增加。于是形成了两个对立的阵营：传统妇科外科医生指责内镜医生轻率且技术不足；而手术腹腔镜的热情支持者则认为剖腹手术已过时，其相关发病率对患者和医疗服务来说不必要地高。在本次文献数据综述中，我们分析剖腹手术和腹腔镜技术，并比较术后生殖成功方面的结果，试图阐明重度子宫内膜异位症的保守性内镜治疗是否只是一个没有前途的不恰当提议，或者由于其有效性，它最终是否会将剖腹手术干预限制在特殊情况下。
