Department of Obstetrics and Gynecology, School of Medicine, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, France.
J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):622-8. doi: 10.1016/j.jmig.2011.06.004. Epub 2011 Jul 28.
This study was undertaken to ascertain whether the incidence of spontaneous pregnancy is increased in infertile women with deep and intraperitoneal endometriosis undergoing extensive surgery compared with those undergoing only intraperitoneal surgery.
Retrospective case control study (Canadian Task Force classification II-1).
University teaching hospital.
Infertile women under the age of 40 years with deep and intraperitoneal endometriosis and no other associated major infertility factors. Only patients with at least 1 year of postoperative follow-up were included.
Intraperitoneal surgery only (group 1) or extensive surgery (group 2) according to a shared decision-making approach.
Among the 34 women in group 1, 6 became pregnant, compared with 8 of the 41 women who had extensive surgery (12-month cumulative probabilities, 24.8% and 11.4%, respectively, and 24-month cumulative probabilities, 24.8% and 23.2%, respectively; p = .82). Perioperative surgical complication rate was higher in group 2 (6/41 versus 0/34; p = .02).
Extensive surgery for intraperitoneal and deep endometriosis in infertile women does not modify global fertility outcome but is associated with a higher complication rate.
本研究旨在确定与仅行腹腔内手术的患者相比，深部和腹腔内子宫内膜异位症的不孕妇女行广泛手术是否会增加自发性妊娠的发生率。
回顾性病例对照研究（加拿大任务组分类 II-1）。
大学教学医院。
年龄小于 40 岁的深部和腹腔内子宫内膜异位症且无其他相关主要不孕因素的不孕妇女。仅纳入至少有 1 年术后随访的患者。
根据共同决策方法仅行腹腔内手术（第 1 组）或广泛手术（第 2 组）。
第 1 组的 34 名妇女中，有 6 名怀孕，而广泛手术的 41 名妇女中有 8 名怀孕（12 个月累积概率分别为 24.8%和 11.4%，24 个月累积概率分别为 24.8%和 23.2%；p=.82）。第 2 组的围手术期手术并发症发生率更高（6/41 与 0/34；p=.02）。
深部和腹腔内子宫内膜异位症不孕妇女的广泛手术并不能改变整体生育结局，但与更高的并发症发生率相关。
