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育龄期年轻女性腹股沟子宫内膜异位症的临床特征及外科治疗

Clinical Characteristics and Surgical Treatment for Inguinal Endometriosis in Young Women of Reproductive Age.

作者信息

Niitsu Hiroaki, Tsumura Hiroaki, Kanehiro Tetsuya, Yamaoka Hiroaki, Taogoshi Hiroyuki, Murao Naoki

机构信息

Department of Surgery and Pediatric Surgery, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan.

Department of Surgery and Pediatric Surgery, Hiroshima City Funairi Citizens Hospital, Hiroshima,

出版信息

Dig Surg. 2019;36(2):166-172. doi: 10.1159/000489827. Epub 2018 Jul 5.

Abstract

AIM

To study the characteristics and surgical treatment of inguinal endometriosis (IEM), which can occur in women of reproductive age.

METHODS

Patients who underwent groin surgery at the Hiroshima City Funairi Citizens Hospital between 2004 and 2017 were retrospectively examined. Patients with IEM were divided into 3 groups based on the site of occurrence as follows: at a hernia sac or hydrocele of Nuck's canal (type I), round ligament (type II), or subcutaneous area (type III). Clinical characteristics were compared among groups.

RESULTS

Of 2,798 patients investigated, 28 were pathologically diagnosed as having IEM with 15, 10, and 3 classified as type I, II, and III respectively. All patients presented with a mass (median 20 mm) and/or bulge that mainly occurred at the right inguinal region. Sixteen patients presented with inguinal pain associated with menstruation. While the groups did not differ in terms of most clinical characteristics, the lack of a preoperative diagnosis of IEM occurred more frequently for type I than for types II and III.

CONCLUSIONS

Because IEM-type I might be underdiagnosed preoperatively, complete resection of a hernia sac or hydrocele of Nuck's canal with subsequent pathological examination is required for women of reproductive age with an inguinal disease.

摘要

目的

研究腹股沟子宫内膜异位症(IEM)的特征及手术治疗方法,该病可发生于育龄女性。

方法

回顾性分析2004年至2017年在广岛市船入市民医院接受腹股沟手术的患者。根据发病部位将IEM患者分为3组:疝囊或努克管鞘膜积液处(I型)、圆韧带处(II型)或皮下区域(III型)。比较各组的临床特征。

结果

在2798例接受调查的患者中,28例经病理诊断为IEM,其中15例、10例和3例分别归类为I型、II型和III型。所有患者均表现为肿块(中位直径20mm)和/或隆起,主要发生在右侧腹股沟区。16例患者出现与月经相关的腹股沟疼痛。虽然各组在大多数临床特征方面无差异,但I型患者术前未诊断出IEM的情况比II型和III型更常见。

结论

由于I型IEM术前可能诊断不足,对于患有腹股沟疾病的育龄女性,需要完整切除努克管的疝囊或鞘膜积液并进行后续病理检查。

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