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首页> 外文期刊>Surgical Endoscopy >Laparoscopic surgical treatment of diaphragmatic endometriosis: A 7-year single-institution retrospective review
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Laparoscopic surgical treatment of diaphragmatic endometriosis: A 7-year single-institution retrospective review

机译：腹腔镜手术治疗diaphragm肌子宫内膜异位症：7年单机构回顾性审查

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Background: Diaphragmatic endometriosis is a rare condition that may cause invalidating epigastric or thoracic pain and catamenial pneumothorax. During the past decades, laparoscopy has been proposed as an optimal tool for diagnosis and surgical eradication of the disease. Methods: We present a retrospective series of consecutive patients affected by diaphragmatic endometriosis, treated by laparoscopy at our institution, during a period of 7 years. Results: Among 3,008 patients with pelvic endometriosis, 46 cases with intraoperative diagnosis of diaphragmatic endometriosis were identified. Operative findings showed multiple diaphragmatic lesions in 32 (69.5 %) patients and single lesions in 14 (30.4 %). Diaphragmatic implants were distributed on the right side in 40 (86.9 %) patients; in 5 patients (10.8 %) they were bilateral and 1 patient had a single lesion on the left hemidiaphragm. Most of the symptomatic patients were treated by complete excision of the nodules, whereas only three patients referring right upper-quadrant abdominal pain and right shoulder catamenial pain had superficial diaphragmatic endometriosis and were treated by diathermocoagulation. Conclusion: Diaphragmatic endometriosis should be included in the concept of complete eradication of endometriosis. This kind of surgery has been shown to be feasible and cost-effective; however, it should be managed in a referral center, by an expert laparoscopic gynecologist with knowledge of oncological surgical techniques, with the support of a general surgeon and a trained anesthesiologist.
机译：背景：Dia肌子宫内膜异位症是一种罕见病，可能导致上腹部或胸痛和月经期气胸无效。在过去的几十年中，腹腔镜已被建议作为诊断和手术根除该疾病的最佳工具。方法：我们回顾性分析了连续7年来在我院接受腹腔镜治疗的diaphragm肌子宫内膜异位症患者的情况。结果：在3008例盆腔子宫内膜异位患者中，鉴定出46例术中诊断为diaphragm肌子宫内膜异位。手术结果显示多发（肌病变32例（69.5％），单发病变14例（30.4％）。 40肌植入物分布在右侧的40例患者中（占86.9％）。在5例患者（占10.8％）中，他们是双侧的，1例患者的左he肌有一个病变。大多数有症状的患者均通过完全切除结节进行治疗，而只有三名转诊右上腹腹痛和右肩月经痛的患者浅表diaphragm肌子宫内膜异位，并接受了透热凝治疗。结论：完全根除子宫内膜异位症的概念应包括Dia肌子宫内膜异位症。这种手术已被证明是可行且具有成本效益的。但是，应在转诊中心由具有肿瘤外科技术知识的专家腹腔镜妇科医师在普通外科医师和训练有素的麻醉师的支持下进行管理。

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