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盆腔外子宫内膜异位症:综述

Extra-pelvic endometriosis: A review.

作者信息

Hirata Tetsuya, Koga Kaori, Osuga Yutaka

机构信息

Department of Obstetrics and Gynecology Doai Kinen Hospital Sumida-ku Japan.

Faculty of Medicine Department of Obstetrics and Gynecology University of Tokyo Tokyo Japan.

出版信息

Reprod Med Biol. 2020 Jul 16;19(4):323-333. doi: 10.1002/rmb2.12340. eCollection 2020 Oct.

Abstract

BACKGROUND

Extra-pelvic endometriosis is a rare type of endometriosis, which occurs in a distant site from gynecological organs. The diagnosis of extra-pelvic endometriosis can be extremely challenging and may result in a delay in diagnosis. The main objective of this review was to characterize abdominal wall endometriosis (AWE) and thoracic endometriosis (TE).

METHODS

The authors performed a literature search to provide an overview of AWE and TE, which are the major types of extra-pelvic endometriosis.

MAIN FINDINGS

Abdominal wall endometriosis includes scar endometriosis secondary to the surgical wound and spontaneous AWE, most of which occur in the umbilicus or groin. Surgical treatment appeared to be effective for AWE. Case reports indicated that the diagnosis and treatment of catamenial pneumothorax or endometriosis-related pneumothorax (CP/ERP) are challenging, and a combination of surgery and postoperative hormonal therapy is essential. Further, catamenial hemoptysis (CH) can be adequately managed by hormonal treatment, unlike CP/ERP.

CONCLUSION

Evidence-based approaches to diagnosis and treatment of extra-pelvic endometriosis remain immature given the low prevalence and limited quality of research available in the literature. To gain a better understanding of extra-pelvic endometriosis, it would be advisable to develop a registry involving a multidisciplinary collaboration with gynecologists, general surgeons, and thoracic surgeons.

摘要

背景

盆腔外子宫内膜异位症是一种罕见的子宫内膜异位症类型,发生在远离妇科器官的部位。盆腔外子宫内膜异位症的诊断极具挑战性,可能导致诊断延迟。本综述的主要目的是描述腹壁子宫内膜异位症(AWE)和胸腔子宫内膜异位症(TE)的特征。

方法

作者进行了文献检索,以概述AWE和TE,这是盆腔外子宫内膜异位症的主要类型。

主要发现

腹壁子宫内膜异位症包括手术伤口继发的瘢痕子宫内膜异位症和自发性AWE,其中大多数发生在脐部或腹股沟。手术治疗对AWE似乎有效。病例报告表明,月经期气胸或子宫内膜异位症相关气胸(CP/ERP)的诊断和治疗具有挑战性,手术和术后激素治疗相结合至关重要。此外,与CP/ERP不同,月经期咯血(CH)可通过激素治疗得到充分控制。

结论

鉴于文献中盆腔外子宫内膜异位症的患病率较低且研究质量有限,基于证据的诊断和治疗方法仍不成熟。为了更好地了解盆腔外子宫内膜异位症,建议建立一个由妇科医生、普通外科医生和胸外科医生多学科合作的登记系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a72/7542014/fc0e3d00320a/RMB2-19-323-g001.jpg

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