Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, 566, Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Republic of Korea.
Department of Obstetrics and Gynecology, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea.
Sci Rep. 2020 Oct 5;10(1):16461. doi: 10.1038/s41598-020-73434-0.
The aim of this study was to evaluate the rate of and risk factors for recurrence ovarian endometrioma after conservative surgery in patients aged 40-49 years. This retrospective, single-center study included 408 women between January 2008 and November 2018. All patients underwent ovarian cyst enucleation, were pathologically diagnosed with ovarian endometrioma and were followed up for ≥ 6 months. Recurrence was defined as a cystic mass with diameter ≥ 2 cm detected by sonography. Recurrence rate after conservative surgery and risk factor of recurrence were analyzed. The median follow-up duration after surgery was 32.0 ± 25.9 months (range 6-125 months). Ovarian endometrioma recurred in 34 (8.3%) of included women and median time to recurrence was 22.4 ± 18.2 months. The cumulative recurrences rate at 12, 24, 36, and 60 months were 3.7%, 6.7%, 11.1%, and 16.7%, respectively. Recurrence was correlated with multilocular cysts (p = 0.038), previous surgical history of ovarian endometrioma (p = 0.006) and salpingectomy (p = 0.043), but not use or duration of post-operative medication. In multivariate analysis, large cyst size (> 5.5 cm) was only risk factor for recurrence in this age group. Post-operative medication did not reduce disease recurrence rate, and thus may be administered for endometriosis-associated pain rather than to prevent recurrence in patients aged 40-49 years.
本研究旨在评估 40-49 岁患者行保守性手术治疗后卵巢子宫内膜异位囊肿复发的发生率和相关危险因素。本回顾性单中心研究纳入了 2008 年 1 月至 2018 年 11 月间的 408 名患者。所有患者均接受卵巢囊肿剔除术，术后病理诊断为卵巢子宫内膜异位囊肿，随访时间≥6 个月。复发定义为超声检查发现直径≥2cm 的囊性肿块。分析保守性手术后的复发率和复发的危险因素。术后中位随访时间为 32.0±25.9 个月（6-125 个月）。34 名（8.3%）患者发生卵巢子宫内膜异位囊肿复发，中位复发时间为 22.4±18.2 个月。术后 12、24、36 和 60 个月的累积复发率分别为 3.7%、6.7%、11.1%和 16.7%。复发与多房性囊肿（p=0.038）、卵巢子宫内膜异位囊肿既往手术史（p=0.006）和输卵管切除术（p=0.043）相关，但与术后用药的使用或持续时间无关。多因素分析显示，大囊肿（>5.5cm）是该年龄段复发的唯一危险因素。术后用药并未降低疾病复发率，因此对于 40-49 岁患者，用药可能是为了缓解子宫内膜异位症相关疼痛，而非预防复发。
