Department of Gynecology, Charité-Universitätsmedizin BerlinVirchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Pathology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Arch Gynecol Obstet. 2021 Jul;304(1):143-155. doi: 10.1007/s00404-021-05971-6. Epub 2021 Feb 3.
To analyze the follow-up results of patients suffering from symptomatic early-stage endometriosis after a consistent laparoscopic peritoneal stripping of the altered peritoneum (peritoneal endometriosis and surrounding inflamed tissue) was performed. This type of endometriosis is resistant to medical therapy and/or impairs fertility.
Using our prospectively maintained database, we were able to identify all symptomatic women with the suspicion of only peritoneal endometriosis who underwent laparoscopy at our endometriosis center over a period of 5 years. All procedures were carried out in a standardized fashion by one single surgeon, who is highly experienced in minimal invasive surgery, and included a suspended hormonal pretreatment for 2 months. Postoperative outcomes including complications, fertility and recurrence rates were analysed.
Laparoscopic peritonectomy was performed on 94 women. Follow-up data were available in 87% of these cases. At the time of surgery, almost all patients tested showed signs of stage I or II endometriosis (44.7 and 48.9%, respectively). More than three-quarters of the women reported pain relief, inter alia, due to the post-surgical hormonal therapy. About one-third of the patients wanted to have children after the procedure. 62% of them became pregnant and the majority did so without the need for assisted reproductive therapy. In seven women a re-operation was performed.
According to our data, a consistent excision of altered peritoneum followed by adjuvant hormonal therapy and multimodal concepts results in better outcomes for the patient, particularly in regards to pregnancy and recurrence rates.
分析经腹腔镜一致行腹膜内异症病灶（腹膜内异症及周围炎症组织）剔除术后，症状性早期内异症患者的随访结果。此类内异症对药物治疗有抗性，或影响生育能力。
利用前瞻性维护的数据库，我们能够确定所有疑似仅腹膜内异症的有症状女性，她们在我们的内异症中心在 5 年内接受腹腔镜检查。所有手术均由一位经验丰富的微创手术医生以标准化方式进行，包括 2 个月的悬吊激素预处理。分析术后结局，包括并发症、生育力和复发率。
94 名女性接受了腹腔镜腹膜切除术。这些病例中有 87%的随访数据可用。在手术时，几乎所有患者都表现出 I 期或 II 期内异症（分别为 44.7%和 48.9%）。超过四分之三的女性报告疼痛缓解，部分原因是术后激素治疗。约三分之一的患者在手术后希望生育。其中 62%的人怀孕，而且大多数人不需要辅助生殖治疗。7 名女性再次手术。
根据我们的数据，一致切除异常腹膜，辅以激素治疗和多模式概念，可为患者带来更好的结局，尤其是在妊娠和复发率方面。
