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前侧盆腔子宫内膜异位症切除术对不孕症的影响。

Effect of Anterior Compartment Endometriosis Excision on Infertility.

作者信息

Centini Gabriele, Afors Karolina, Alves Joao, Argay István Máté, Koninckx Philippe R, Lazzeri Lucia, Monti Giorgia, Zupi Errico, Wattiez Arnaud

机构信息

Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

Whittington Hospital, London, United Kingdom.

出版信息

JSLS. 2018 Oct-Dec;22(4). doi: 10.4293/JSLS.2018.00067.

Abstract

BACKGROUND AND OBJECTIVES

Laparoscopic surgical excision of bladder nodules has been demonstrated to be effective in relieving associated painful symptoms; the data are lacking concerning the impact of anterior compartment endometriosis on infertility. We conducted this study to evaluate whether or not the surgical excision of deep endometriosis affecting the anterior compartment plays a role in restoring fertility.

METHODS

This multicentre, retrospective study included a group of 55 patients presenting with otherwise-unexplained infertility who had undergone laparoscopic excision of anterior compartment endometriosis with histological confirmation. Patient medical records and operative reports were reviewed. Telephone interviews were conducted for long-term followup of fertility outcomes.

RESULTS

The pregnancy rate following surgical excision of endometriotic lesions was 44% (n = 11) among those with anterior compartment involvement alone and 50% (n = 15) in case of posterior lesions association without any significant difference. The symptoms related to bladder endometriosis resolved in the 84.2% of the cases with a recurrence rate of 1.8% at the 2-year followup not requiring further surgery.

CONCLUSION

Laparoscopic excision of anterior compartment endometriosis is effective in restoring fertility in patients with otherwise-unexplained infertility and in treating endometriosis-related symptoms.

摘要

背景与目的

腹腔镜手术切除膀胱结节已被证明可有效缓解相关疼痛症状;但关于前盆腔子宫内膜异位症对不孕的影响的数据尚缺。我们开展本研究以评估手术切除累及前盆腔的深部子宫内膜异位症是否对恢复生育能力有作用。

方法

这项多中心回顾性研究纳入了一组55例不明原因不孕的患者,这些患者均接受了腹腔镜下前盆腔子宫内膜异位症切除术且有组织学确诊。查阅了患者的病历和手术报告。通过电话访谈对生育结局进行长期随访。

结果

仅累及前盆腔的患者中,手术切除子宫内膜异位病灶后的妊娠率为44%(n = 11),伴有后盆腔病灶的患者妊娠率为50%(n = 15),两者无显著差异。84.2%的膀胱子宫内膜异位症相关症状得到缓解,在2年随访时复发率为1.8%,无需进一步手术。

结论

腹腔镜切除前盆腔子宫内膜异位症对不明原因不孕患者恢复生育能力及治疗子宫内膜异位症相关症状有效。

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