Adamson G D, Hurd S J, Pasta D J, Rodriguez B D
Fertility Physicians of Northern California, Palo Alto.
Fertil Steril. 1993 Jan;59(1):35-44.
To assess the hypothesis that pregnancy rates (PRs) after operative laparoscopy (Laparoscopy Group) for endometriosis treatment would be equal to or greater than diagnostic laparoscopy only (No Treatment Group), diagnostic laparoscopy with medical treatment (Medical Treatment Group), and laparotomy (Laparotomy Group).
Prospectively recorded data were analyzed to identify significant variables affecting PRs. These variables were statistically controlled for using survival analysis with multiple fixed covariates to compare operative laparoscopy PRs versus other treatment PRs.
Treatment was performed by the senior author in a referral reproductive endocrinology and surgery private practice.
Five hundred seventy-nine infertile women were diagnosed with endometriosis. A subset (n = 258) considered to have endometriosis only was evaluated separately (Endometriosis-Only Subset).
Treatment groups included: No Treatment Group, Medical Treatment Group, Laparoscopy Group, and Laparotomy Group.
MAIN OUTCOME MEASURE(S): Pregnancy was used as the indicator of treatment success.
Laparoscopy Group PRs were at least equal to all other treatment groups and were significantly higher than some other treatment groups in some comparisons.
Operative laparoscopy is the treatment of choice for infertile women with endometriosis unless they have severe tubal and/or fimbrial disease.
评估以下假设，即针对子宫内膜异位症治疗的手术腹腔镜检查术后（腹腔镜检查组）的妊娠率（PRs）将等于或高于仅进行诊断性腹腔镜检查（未治疗组）、诊断性腹腔镜检查联合药物治疗（药物治疗组）以及剖腹手术（剖腹手术组）后的妊娠率。
对前瞻性记录的数据进行分析，以确定影响妊娠率的显著变量。使用具有多个固定协变量的生存分析对这些变量进行统计学控制，以比较手术腹腔镜检查的妊娠率与其他治疗的妊娠率。
治疗由资深作者在一家转诊生殖内分泌与外科私人诊所进行。
579名不孕女性被诊断为子宫内膜异位症。一个仅被认为患有子宫内膜异位症的子集（n = 258）被单独评估（仅子宫内膜异位症子集）。
治疗组包括：未治疗组、药物治疗组、腹腔镜检查组和剖腹手术组。
妊娠被用作治疗成功的指标。
腹腔镜检查组的妊娠率至少与所有其他治疗组相等，并且在某些比较中显著高于其他一些治疗组。
手术腹腔镜检查是患有子宫内膜异位症的不孕女性的首选治疗方法，除非她们患有严重的输卵管和/或伞端疾病。
