Department of Gynaecology and Obstetrics, and Groupe de recherche EA 4308 Spermatogenesis and Male Gamete Quality, Rouen University Hospital, 76031 Rouen, France.
Hum Reprod. 2010 Jun;25(6):1428-32. doi: 10.1093/humrep/deq069. Epub 2010 Apr 8.
The aim of this study was to estimate whether or not the size of an endometrioma is related to the thickness of the ovarian parenchyma inadvertently excised along with the cyst wall.
We performed a retrospective study including 35 women who had undergone endometrioma cystectomy, using an ovarian tissue sparing procedure. In total 38 specimens were studied by three pathologists as three women presented bilateral localizations, and all cyst diameters measured at least 30 mm. For each endometrioma, serial sections were performed, and on each section four different sites were randomly chosen to measure the thickness of glandular epithelium and stroma, of subjacent fibrosis, depending on the cyst, and of the ovarian parenchyma removed with the cyst. The diameter of the ovary was measured preoperatively either by MRI or ultrasound, and the area of the internal wall was then calculated. The relationships between the mean thickness of ovarian parenchyma removed and the variables were estimated and a multiple regression model identified independent predictors for ovarian parenchyma thickness.
Adjacent ovarian tissue was found in 37 cases (97%). The mean thickness of ovarian tissue removed was 1173 +/- 711 microm and that of the cyst wall was 851 +/- 499 microm. The thickness of the ovarian parenchyma removed presented a direct proportional relationship with cyst diameter (P = 0.015), and consequently with cyst wall area (P = 0.032). This relationship with cyst diameter was independent after adjustment on other variables (P = 0.032).
Endometrioma cystectomy even though performed with an accurate surgical technique leads to significant ovarian tissue removal, the thickness of which increases proportionally with cyst diameter.
本研究旨在评估卵巢子宫内膜异位症囊肿的大小是否与囊肿壁切除时无意中切除的卵巢实质的厚度有关。
我们进行了一项回顾性研究，纳入了 35 名接受卵巢子宫内膜异位症囊肿切除术的患者，采用卵巢组织保留术。共有 38 个标本由 3 名病理学家进行研究，因为 3 名患者存在双侧病变，所有囊肿直径至少为 30mm。对于每个子宫内膜异位症囊肿，进行了连续切片，在每个切片上随机选择 4 个不同的部位测量腺体上皮和基质的厚度、根据囊肿选择的下方纤维化的厚度以及与囊肿一起切除的卵巢实质的厚度。术前通过 MRI 或超声测量卵巢的直径，然后计算内部壁的面积。估计卵巢实质切除的平均厚度与变量之间的关系，并建立多元回归模型以确定卵巢实质厚度的独立预测因子。
在 37 例（97%）中发现了相邻的卵巢组织。切除的卵巢实质的平均厚度为 1173±711μm，囊肿壁的平均厚度为 851±499μm。切除的卵巢实质厚度与囊肿直径呈直接比例关系（P=0.015），并且与囊肿壁面积呈正相关（P=0.032）。这种与囊肿直径的关系在调整其他变量后仍然独立（P=0.032）。
即使采用精确的手术技术进行卵巢子宫内膜异位症囊肿切除术，也会导致显著的卵巢实质切除，其厚度与囊肿直径成比例增加。
