Yela Daniela Angerame, Trigo Lucas, Benetti-Pinto Cristina Laguna
Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
Rev Bras Ginecol Obstet. 2017 Aug;39(8):403-407. doi: 10.1055/s-0037-1603965. Epub 2017 Jun 21.
To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section ( = 0.18), previous laparotomy ( = 0.11), previous laparoscopy ( = 0.12) and postoperative hormone therapy ( = 0.51). Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.
为确定腹壁子宫内膜异位症(AWE)的临床和流行病学特征,以及该病的发生率和复发因素。2004年至2014年在坎皮纳斯州立大学对52例AWE女性患者进行了一项回顾性研究。在231例为诊断子宫内膜异位症而进行的手术中,发现52例女性患有腹壁子宫内膜异位症(AWE)。计算了这些女性临床特征的频率、均值和标准差,以及AWE的复发率。为确定疾病复发的危险因素,采用了Fisher精确检验。患者的平均年龄为30.71±5.91岁。主要临床表现为疼痛(98%)和肿块感(36.5%)。我们观察到,这些女性中有94%至少接受过1次剖宫产,73%曾使用药物进行子宫内膜异位症的术后控制。病变最常位于剖宫产瘢痕处(65%)。该病的复发率为26.9%。所有14例复发的女性在前次手术中手术切缘均受到影响。复发性AWE与既往剖宫产(P=0.18)、既往剖腹手术(P=0.11)、既往腹腔镜手术(P=0.12)及术后激素治疗(P=0.51)之间均无相关性。有剖宫产史且出现局部疼痛或肿块的女性应接受AWE检查。AWE的复发率很高,尤其是首次手术不恰当且手术切缘受到影响时。