Department of Obstetrics and Gynecology, Linz General Hospital, Allgemeines Krankenhaus Linz, Krankenhausstrasse 9, 4021, Linz, Austria.
Arch Gynecol Obstet. 2013 May;287(5):941-5. doi: 10.1007/s00404-012-2647-1. Epub 2012 Dec 2.
The most widely accepted classification for endometriosis is the Revised American Society for Reproductive Medicine (rASRM) system, but this does not take deeply infiltrating endometriosis (DIE) into account. The Enzian classification enables clinicians to classify DIE. Due to complexity and partial overlap with rASRM, it was revised for a second time in February 2011. Using both the systems to classify lesions would be inappropriate, as they refer to different locations. The aim of this study was to analyze whether the revised Enzian classification is easier to use and avoids duplicate classifications.
Retrospective study of 460 women admitted for endometriosis.
One hundred and eighty-seven of 460 patients (41 %) had histologically confirmed DIE based on the revised Enzian classification. Further classification of these 187 patients using Enzian revealed 270 retroperitoneal lesions, as some patients had several DIE-type lesions simultaneously: 66 in compartment A (rectovaginal septum, vagina), 112 in compartment B (sacrouterine ligaments, pelvic wall), 58 in compartment C (bowel), 15 with adenomyosis uteri, 7 with bladder involvement, 8 with intrinsic involvement of the ureter, and 4 with bowel involvement. All 270 lesions were classified using Enzian alone and not with the rASRM score. There were no duplicate classifications (rASRM and Enzian).
The revised Enzian classification is an excellent complement to the rASRM score for morphological description of DIE.
最广为接受的子宫内膜异位症分类是修订后的美国生殖医学学会（rASRM）系统，但该系统并未考虑深部浸润性子宫内膜异位症（DIE）。恩齐安分类使临床医生能够对 DIE 进行分类。由于其复杂性和与 rASRM 的部分重叠，它于 2011 年 2 月进行了第二次修订。同时使用这两种系统对病变进行分类是不合适的，因为它们涉及不同的部位。本研究旨在分析修订后的恩齐安分类是否更易于使用并避免重复分类。
对 460 名因子宫内膜异位症入院的女性进行回顾性研究。
根据修订后的恩齐安分类，460 名患者中有 187 名（41%）患者的组织学证实存在 DIE。对这 187 名患者进一步使用恩齐安分类，发现有 270 个腹膜后病变，因为一些患者同时存在几种 DIE 型病变：66 个位于 A 区（直肠阴道隔，阴道），112 个位于 B 区（骶韧带，骨盆壁），58 个位于 C 区（肠），15 个有子宫腺肌症，7 个有膀胱受累，8 个有输尿管内在受累，4 个有肠受累。所有 270 个病变均仅使用恩齐安分类，而不使用 rASRM 评分。没有重复分类（rASRM 和恩齐安）。
修订后的恩齐安分类是 rASRM 评分对 DIE 形态描述的极好补充。
