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接受腹腔镜手术及术后抑制治疗的卵巢子宫内膜异位症患者的复发率

Recurrence rate of ovarian endometriosis in patients treated with laparoscopic surgery and postoperative suppressive therapy.

作者信息

Dimitrijevic D, Vasiljevic M, Anicic R, Brankovic S, Ristic A, Devic A

出版信息

Clin Exp Obstet Gynecol. 2015;42(3):339-43.

Abstract

INTRODUCTION

The testing represented a prospective study that was performed at the Gynaecology and Obstetrics Clinic "Narodni Front" in Belgrade during a two-year period. The study encompassed female patients with ovarian endometrioma operated with laparoscopic surgery. The research objective was to determine the percentage of occurrence of relapses in patients operated for endometriosis of the ovary in relation to the stage of the disease and the type of performed operation, and which were receiving suppressive therapy with gonadotropin-releasing hormone (GnRH) analogues after the surgery compared to those who were not receiving suppressive therapy after the operation.

MATERIALS AND METHODS

The recurrence of endometriosis on the ovary of the test and control groups was monitored during the first year after surgery. In all patients ultrasound checks were done every month during the first six months after surgery, and then every three months for the next six months. In all patients in whom the recurrence, i.e. endometrioma on the ovary larger than three cm was revealed postoperatively by ultrasound, the laparoscopic removal of the endometrioma was performed again as well as the histopathological examination of the material.

RESULTS AND CONCLUSION

There was no statistically significant difference in the distribution of recurrence of endometriosis between the groups formed according to the type of surgical technique (cystectomy or cystotomy). The recurrence of endometriosis occurred later in the group of patients in which the treatment GnRH analogues was applied after the surgical treatment. The recurrence of endometriosis in more severe stages (Stage III and IV) occurs later in the group of patients in which the treatment GnRH analogues is applied after the surgical treatment.

摘要

引言

该测试是一项前瞻性研究,在贝尔格莱德的“人民阵线”妇产科诊所进行,为期两年。该研究纳入了接受腹腔镜手术治疗卵巢子宫内膜异位症的女性患者。研究目的是确定卵巢子宫内膜异位症手术患者复发的百分比与疾病阶段和所施行手术类型的关系,以及与术后未接受促性腺激素释放激素(GnRH)类似物抑制治疗的患者相比,术后接受该抑制治疗的患者的复发情况。

材料与方法

在术后第一年监测试验组和对照组卵巢子宫内膜异位症的复发情况。所有患者在术后前六个月每月进行超声检查,接下来的六个月每三个月进行一次。对于所有术后超声显示复发(即卵巢子宫内膜瘤大于3厘米)的患者,再次进行腹腔镜下子宫内膜瘤切除及材料的组织病理学检查。

结果与结论

根据手术技术类型(囊肿切除术或囊肿切开术)分组,两组间子宫内膜异位症复发分布无统计学显著差异。手术治疗后应用GnRH类似物治疗的患者组中,子宫内膜异位症复发出现得较晚。手术治疗后应用GnRH类似物治疗的患者组中,更严重阶段(III期和IV期)的子宫内膜异位症复发出现得较晚。

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