Department of Interventional Radiology and Oncology, Tenon Hospital, Sorbonne University, Paris, France.
Department of Nephrology, Tenon Hospital, Sorbonne University, Paris, France.
J Vasc Interv Radiol. 2023 Jul;34(7):1192-1198. doi: 10.1016/j.jvir.2023.03.025. Epub 2023 Mar 30.
To retrospectively evaluate the relief of pain after percutaneous image-guided cryoablation of symptomatic extraperitoneal endometriosis (EE).
From 2017 to 2022, cryoablation of EE was performed at a single institution on a total of 47 lesions in 42 consecutive patients (median age, 37 years; interquartile range [IQR], 33-39.5 years). Patient and procedural characteristics were reviewed retrospectively. Tolerance and outcomes in terms of pain and patient satisfaction were evaluated.
The median follow-up duration was 13.5 months (IQR, 1.1-37.7 months) after cryoablation. The median pain-free survival rate was 93.8% (95% confidence interval [CI], 77.3-98.4) at 6 months and 82.7% (95% CI, 58.8-93.5) after 12 months. Pain decreased from a median of 8/10 (IQR, 7-9) on the visual analog scale to 0/10 (IQR, 0-1) at the last follow-up (P < .0001). The median Patient Global Impression of Change score recorded at the last follow-up was 1/7 (IQR, 1-2). The efficacy rate of cryoablation to avoid secondary surgery was 92.8% (39/42) per patient and 93.6% (44/47) per nodule treated. Four patients (9.5%, 4/42) experienced an adverse event in the days following the procedure, and 1 patient (2%) experienced a severe adverse event.
Percutaneous cryoablation is safe and effective in significantly reducing pain and obtaining local control of EE.
回顾性评估经皮影像引导下冷冻消融治疗症状性腹膜外子宫内膜异位症（EE）的疼痛缓解情况。
2017 年至 2022 年，在一家机构对 42 例连续患者的 47 个病变进行了 EE 的冷冻消融治疗（中位年龄 37 岁；四分位间距[IQR]，33-39.5 岁）。回顾性审查患者和手术特点。评估疼痛和患者满意度方面的耐受性和结果。
冷冻消融后中位随访时间为 13.5 个月（IQR，1.1-37.7 个月）。冷冻消融后 6 个月和 12 个月时无疼痛的中位生存率分别为 93.8%（95%可信区间[CI]，77.3-98.4）和 82.7%（95% CI，58.8-93.5）。疼痛从视觉模拟评分的中位数 8/10（IQR，7-9）降至最后一次随访时的 0/10（IQR，0-1）（P<0.0001）。最后一次随访时记录的患者总体印象变化评分中位数为 1/7（IQR，1-2）。冷冻消融避免二次手术的有效率为每位患者 92.8%（39/42），每枚结节 93.6%（44/47）。4 名患者（9.5%，4/42）在术后几天出现不良事件，1 名患者（2%）出现严重不良事件。
经皮冷冻消融术安全有效，可显著减轻疼痛，并获得 EE 的局部控制。
