Nezhat Camran, Amirlatifi Nikki, Najmi Zahra, Tsuei Angie
Center For Special Minimally Invasive and Robotic Surgery, Camran Nezhat Institute, Woodside, CA 94061, USA.
J Clin Med. 2024 Dec 13;13(24):7602. doi: 10.3390/jcm13247602.
Endometriosis is a systemic, inflammatory, estrogen-dependent condition characterized by endometrial stroma and gland-like lesions outside of the uterus. It causes a range of symptoms, notably chronic pelvic pain, infertility and organ dysfunction. Thoracic endometriosis syndrome (TES) has been described as endometriosis that is found in the lung parenchyma, pleura and diaphragm. It may be asymptomatic or present with symptoms of catamenial pneumothorax, hemothorax, hemoptysis, isolated chest pain, shoulder pain or findings of lung nodules. The aim of this review is to provide a comprehensive overview of thoracic endometriosis syndrome (TES), including its clinical presentation, diagnostic challenges, and current management strategies. This review aims to highlight the importance of a multidisciplinary approach in the treatment of TES, emphasizing conservative management and the role of minimally invasive surgical techniques for refractory cases. Thoracic endometriosis syndrome appears to be a marker of severe endometriosis. As much as possible, the patient with TES is managed conservatively, with surgery reserved for refractory cases. When surgery is recommended, the procedure is conducted through a multidisciplinary minimally invasive approach, with video-assisted thoracoscopic surgery (VATS) and video-assisted laparoscopy. Meticulous intraoperative survey, the removal of endometriosis implants with and without robotic assistance and post-operative hormonal therapy may be recommended to prevent recurrence.
子宫内膜异位症是一种全身性、炎症性、雌激素依赖性疾病，其特征是子宫外出现子宫内膜间质和腺样病变。它会引发一系列症状，尤其是慢性盆腔疼痛、不孕和器官功能障碍。胸腔子宫内膜异位症综合征（TES）被描述为在肺实质、胸膜和膈肌中发现的子宫内膜异位症。它可能无症状，或表现为经期气胸、血胸、咯血、孤立性胸痛、肩痛或肺结节等症状。本综述的目的是全面概述胸腔子宫内膜异位症综合征（TES），包括其临床表现、诊断挑战和当前的管理策略。本综述旨在强调多学科方法在TES治疗中的重要性，强调保守治疗以及微创外科技术在难治性病例中的作用。胸腔子宫内膜异位症综合征似乎是重度子宫内膜异位症的一个标志。对于TES患者，尽可能采取保守治疗，手术仅用于难治性病例。当建议进行手术时，通过多学科微创方法进行操作，采用电视辅助胸腔镜手术（VATS）和电视辅助腹腔镜手术。可能建议进行细致的术中探查，在有或无机器人辅助的情况下切除子宫内膜异位植入物，并进行术后激素治疗以预防复发。
