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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation
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Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation

机译：二线保守，腹腔镜囊肿摘除术后卵巢子宫内膜瘤复发

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Objective We sought to evaluate the cumulative recurrence rate of endometrioma after a second-line, conservative, laparoscopic endometriotic cyst enucleation and to analyze the factors that influence the recurrence of endometrioma. Study Design A multicenter retrospective cohort study was performed at 3 gynecologic surgery centers from January 2000 through December 2010. Patients surgically treated by laparoscopic enucleation of endometriotic cysts on 2 previous occasions were selected. All patients were aged <40 years at the time of the primary surgery and were followed up for at least 6 months. Endometrioma recurrence was considered when transvaginal sonography indicated a cystic mass with a diameter of ≥20 mm. Results In total, 183 patients were followed up for 33.2 ± 27.7 months (range, 6-121 months). Thirty-eight (20.8%) patients experienced recurrence after the second-line surgery and 24 (13.1%) patients underwent a third surgery. The median time to recurrence was 24 ± 3.36 months (SEM) (range, 3-72 months). The cumulative recurrence rates per patient at 12, 24, 36, and 60 months after the second-line surgery were 7.7%, 13.7%, 21.3%, and 37.5%, respectively. After multivariate analysis and analysis of covariance, the revised American Fertility Society score and stage were significantly higher in patients who experience a third recurrence of endometrioma. Conclusion The cumulative recurrence rate of ovarian endometrioma after a second-line surgery appears to be correlated to the duration of follow-up. Severe endometriosis at the second-line surgery seems to be a factor associated with a high recurrence risk. Physicians should be cautious with regard to the postoperative management of these patients.
机译：目的我们试图评估二线保守，腹腔镜子宫内膜异位囊肿摘除术后子宫内膜瘤的累积复发率，并分析影响子宫内膜瘤复发的因素。研究设计自2000年1月至2010年12月，在3个妇科手术中心进行了一项多中心回顾性队列研究。选择了两次腹腔镜摘除子宫内膜异位囊肿的手术患者。在初次手术时，所有患者年龄均<40岁，并至少随访了6个月。当经阴道超声检查发现直径≥20 mm的囊性肿块时，考虑子宫内膜瘤复发。结果总共对183例患者进行了随访，随访时间为33.2±27.7个月（范围6-121个月）。 38例（20.8％）患者在二线手术后经历了复发，而24例（13.1％）进行了第三次手术。复发的中位时间为24±3.36个月（SEM）（范围3-72个月）。每例患者在二线手术后第12、24、36和60个月的累积复发率分别为7.7％，13.7％，21.3％和37.5％。经过多变量分析和协方差分析，修订的美国生育协会评分和分期在经历子宫内膜瘤第三次复发的患者中明显更高。结论二线手术后卵巢子宫内膜瘤的累积复发率似乎与随访时间有关。在二线手术中严重的子宫内膜异位似乎是与高复发风险相关的因素。内科医师应谨慎对待这些患者的术后管理。

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