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首页> 外文期刊>The journal of obstetrics and gynaecology research >Recurrence of ovarian endometrioma after laparoscopic excision: Risk factors and prevention
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Recurrence of ovarian endometrioma after laparoscopic excision: Risk factors and prevention

机译：腹腔镜切除术后卵巢子宫内膜瘤复发：危险因素及预防

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Aim: The aim of this study was to assess the cut-off age of the risk factors for postoperative recurrence of ovarian endometriomas and to evaluate the end-points of follow-up after laparoscopic excision of ovarian endometriomas. Material and Methods: We retrospectively reviewed 167 patients who underwent laparoscopic excision of ovarian endometriomas at our hospital between 2000 and 2009, and followed up the patients until 2010. Following surgery, patients chose to receive gonadotrophin-releasing hormone agonist, oral contraceptive pills (OCP), dienogest, or no medication and underwent regular ultrasonographic examinations. Potential risk factors for recurrence, including age at surgery, were assessed in the patients receiving no medication. Postoperative recurrence, defined as re-appearance of an ovarian endometrioma > 2 cm in size, was assessed for each treatment group. Results: Age at surgery was the only significant risk factor for recurrence, at a cut-off of 32 years, obtained through receiver-operator curve analysis. In patients not receiving medication, the recurrence rate gradually increased up to 50% over 5 years; there was no recurrence 5 years after surgery. Although no recurrence was seen in patients during continuous treatment with OCP or dienogest, the disease recurred in 55.5% of patients after discontinuing OCP. Conclusions: Although adjuvant therapy for all patients may represent overtreatment, the findings of the present study suggest that, in the interest of fertility preservation, continuous postoperative hormonal treatment should be administered, at least to patients younger than 32 years. In patients who decline hormonal treatment, we recommend that they undergo follow-up for recurrence until 5 years after surgery.
机译：目的：本研究的目的是评估卵巢子宫内膜瘤术后复发的危险因素的截止年龄，并评估腹腔镜切除卵巢子宫内膜瘤后的随访终点。资料与方法：我们回顾性分析了2000年至2009年间在我院进行腹腔镜切除卵巢子宫内膜异位症的167例患者，并随访至2010年。手术后，患者选择接受促性腺激素释放激素激动剂，口服避孕药（OCP） ），无妊娠或无药物治疗，并定期进行超声检查。在未接受药物治疗的患者中评估了潜在的复发风险因素，包括手术年龄。评估每个治疗组的术后复发率，定义为再次出现大小> 2 cm的卵巢子宫内膜瘤。结果：手术年龄是复发的唯一重要危险因素，截止到32岁，是通过接受者－操作者曲线分析获得的。在未接受药物治疗的患者中，复发率在5年内逐渐增加至50％。手术后5年没有复发。尽管在持续使用OCP或去死孕的过程中未见复发，但停止OCP后该病复发的患者占55.5％。结论：尽管对所有患者的辅助治疗都可能代表过度治疗，但本研究的发现表明，为了保持生育力，至少应对32岁以下的患者进行连续的激素治疗。对于拒绝激素治疗的患者，我们建议对他们进行随访直至复发，直到术后5年。

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