Delbos L, Bouet P E, Catala L, Lefebvre C, Teyssedou C, Descamps P, Legendre G
Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
J Gynecol Obstet Hum Reprod. 2018 Oct;47(8):359-364. doi: 10.1016/j.jogoh.2018.04.005. Epub 2018 Apr 11.
The principal objective of our study was to assess women's quality of life (QoL) after surgery for Deep Endometriosis (DE), according to the surgical technique used.
Qualitative single-center survey in the department of obstetrics and gynecology, Angers University Hospital Center, France. All women who underwent surgery for DE from January 2011 to December 2015 were contacted by phone. The Endometriosis Health Profile-5 score was used to assess QoL before and after the surgery. Fifty-two women (response rate=86%) were included and classified into 3 groups according to the surgical technique used: simple shaving, shaving exclusively or in part by plasma vaporization (plasma), and resection.
The 3 groups were comparable for surgical history, preoperative QoL score, and characteristics of endometriotic lesions (size and site). All DE symptoms and QoL scores improved significantly after the surgery, all techniques combined (P<0.01). QoL scores for women who had plasma shaving or complete resection were significantly higher than those for women with simple shaving (respectively, 375 [225-800] and 450 [-50 to 725] vs 275 [-100 to 600]; P=0.04). Self-image significantly improved only in the plasma group (P=0.03). The complete resection group had longer hospitals stays than the other groups (P=0.001), as well as a higher surgical revision rate (23% vs 0%; P=0.02).
Plasma and complete resection improved QoL similarly for women with DE, both more than shaving alone. The advantage of plasma vaporization lies in the lesser morbidity and better self-image, both better than in women with resection.
我们研究的主要目的是根据所采用的手术技术，评估深部子宫内膜异位症（DE）患者术后的生活质量（QoL）。
在法国昂热大学医院中心妇产科进行的定性单中心调查。通过电话联系了2011年1月至2015年12月期间接受DE手术的所有女性。采用子宫内膜异位症健康状况-5评分来评估手术前后的生活质量。纳入了52名女性（应答率=86%），并根据所采用的手术技术分为3组：单纯刮除、单纯或部分采用等离子汽化（等离子）刮除以及切除。
3组在手术史、术前生活质量评分以及子宫内膜异位症病变特征（大小和部位）方面具有可比性。所有技术综合起来，术后所有DE症状和生活质量评分均显著改善（P<0.01）。接受等离子刮除或完全切除的女性的生活质量评分显著高于单纯刮除的女性（分别为375[225 - 800]和450[-50至725]，而单纯刮除组为275[-100至600]；P = 0.04）。仅在等离子组中自我形象显著改善（P = 0.03）。完全切除组的住院时间比其他组更长（P = 0.001），手术翻修率也更高（23%对0%；P = 0.02）。
对于DE女性患者，等离子汽化和完全切除在改善生活质量方面效果相似，均优于单纯刮除。等离子汽化的优势在于发病率较低且自我形象更好，两者均优于切除手术的女性。
