Cazzato Roberto Luigi, Shaygi Behnam, Bertolotti Lorenzo, Weiss Julia, Host Aline, Faller Emilie, Gangi Afshin
Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Interventional and Diagnostic Radiology, London North West University Healthcare NHS Trust, London, UK.
Cardiovasc Intervent Radiol. 2025 Apr;48(4):543-550. doi: 10.1007/s00270-025-04017-7. Epub 2025 Mar 19.
To report the pain relief and procedure-related outcomes of percutaneous cryoablation (CA) of painful endometriosis deposits in unusual anatomic locations.
A retrospective search of institutional radiological information system identified a total of 15 patients (median age 35.5 years; interquartile ranges-IQR 33-38). Patients and lesions specific data as well as procedural and follow-up information were collected, analyzed, and presented using descriptive statistical methods.
A total of 16 painful target lesions situated in the umbilicus (7/16; 43.8%), diaphragm (4/16; 25.0%), inguinal canal (3/16; 18.8%), and within the muscular layers of the uterus (i.e., adenomyosis; 2/16; 12.4%) underwent CA. The median of the largest diameter of the target lesions was 19 mm (IQR 13-22.3). Primary and secondary rates of complete pain relief were achieved in 86.7% (13/15 patients) and 93.3% (14/15 patients; one patient receiving additional CA for recurring pain) of patients, respectively. Each lesion underwent one single intervention, thus accounting for a total of 16 CA procedures. Eleven interventions were carried out under general anesthesia (11/16; 68.8%), with combination of ultrasound and cross-sectional imaging (CT or MRI) being the most used modality for image guidance (10/16; 62.5%). Nearly all interventions (15/16; 93.8%) required adjunctive protective measures with hydrodissection (13/16; 81.3%) and combination of hydrodissection and cutaneous protection with warm saline filled gloves (9/16; 56.3%) being the two most common protective measures. Two (2/16; 12.5%) complications were noted.
Percutaneous CA of painful endometriosis deposits in unusual anatomic locations seems highly effective and safe.
报告经皮冷冻消融术（CA）治疗解剖位置特殊的疼痛性子宫内膜异位结节的疼痛缓解情况及与手术相关的结果。
对机构放射信息系统进行回顾性检索，共纳入15例患者（中位年龄35.5岁；四分位间距-IQR 33-38）。收集患者和病变的具体数据以及手术和随访信息，采用描述性统计方法进行分析和呈现。
共有16个疼痛性靶病变接受了CA治疗，这些病变位于脐部（7/16；43.8%）、膈肌（4/16；25.0%）、腹股沟管（3/16；18.8%）以及子宫肌层内（即子宫腺肌病；2/16；12.4%）。靶病变最大直径的中位数为19 mm（IQR 13-22.3）。患者的完全疼痛缓解的一级和二级率分别为86.7%（13/15例患者）和93.3%（14/15例患者；1例患者因复发性疼痛接受了额外的CA治疗）。每个病变均接受了单次干预，因此总共进行了16次CA手术。11次干预在全身麻醉下进行（11/16；68.8%），超声与断层成像（CT或MRI）联合是最常用的图像引导方式（10/16；62.5%）。几乎所有干预（15/16；93.8%）都需要辅助保护措施，水分离术（13/16；81.3%）以及水分离术与用温盐水填充手套的皮肤保护联合（9/16；56.3%）是两种最常见的保护措施。记录到2例（2/16；12.5%）并发症。
经皮CA治疗解剖位置特殊的疼痛性子宫内膜异位结节似乎非常有效且安全。
