Long-term risk of repeated surgeries in women managed for endometriosis: a 1,092 patient-series

子宫内膜异位症 医学 子宫腺肌病 不育 子宫切除术 外科 前瞻性队列研究 回顾性队列研究 直肠 怀孕 妇科 生物 遗传学
作者
Horace Roman,Isabella Chanavaz‐Lacheray,Clotilde Hennetier,Jean‐Jacques Tuech,Thomas Dennis,Éric Verspyck,Benjamin Merlot
出处
期刊:Fertility and Sterility [Elsevier]
卷期号:120 (4): 870-879 被引量:13
标识
DOI:10.1016/j.fertnstert.2023.05.156
摘要

To assess the long-term risk of repeated surgery in women undergoing complete excision of endometriosis by an experienced surgeon and to identify circumstances leading up to repeat surgery.Retrospective study based on data recorded in a large prospective database.University Hospital.A total of 1,092 patients managed for endometriosis, from June 2009 to June 2018, by one surgeon.Complete excision of endometriosis lesions.The recording of a repeated surgery linked to endometriosis performed during follow-up.Endometriosis was exclusively superficial in 122 patients (11.2%) and 54 women (5%) had endometriomas without associated deep endometriosis nodules. Deep endometriosis was managed in 916 women (83.9%), leading to infiltration or not of the bowel in 688 (63%) and 228 (20.9%) patients, respectively. A majority of patients were managed for severe endometriosis infiltrating the rectum (58.4%). Mean and median follow-up was 60 months. A total of 155 patients underwent a repeated surgery relating to endometriosis; 108 procedures were required because of recurrences (9.9%), 39 surgeries were related to the management of infertility by assisted reproductive techniques (3.6%), and in 8 surgeries, a direct relationship between surgery and endometriosis was probable but not certain (0.8%). The majority of procedures involved hysterectomy for adenomyosis (n=45, 4.1%). The probability of requiring repeated surgery at 1, 3, 5, 7, and 10 years was 3%, 11%, 18%, 23%, and 28%, respectively. Cox's multivariate model identified postoperative pregnancy and hysterectomy as being statistically significant independent predictors for a reduction in the probability of having a repeated surgery, after adjustment on continuous postoperative amenorrhea, the main localization of the disease, and management for endometriosis infiltrating the rectum during the first surgery.Up to 28% of patients may require a repeated surgical procedure during the 10 years after complete excision of endometriosis. Conservation of the uterus is followed by an increased risk of repeated surgery. The study is based on outcomes resulting from a single surgeon, which limits the generalizability of results.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
吐司炸弹完成签到,获得积分10
4秒前
LJ_2完成签到 ,获得积分10
4秒前
mayfly完成签到,获得积分10
4秒前
灵犀完成签到,获得积分10
8秒前
小白兔完成签到 ,获得积分10
26秒前
zhenzhen完成签到,获得积分10
27秒前
29秒前
危机的慕卉完成签到 ,获得积分10
29秒前
changfox完成签到,获得积分10
29秒前
gabee完成签到 ,获得积分10
34秒前
优雅yu发布了新的文献求助10
34秒前
穆一手完成签到 ,获得积分10
40秒前
46秒前
outbed发布了新的文献求助30
52秒前
会发芽完成签到 ,获得积分10
1分钟前
细心的如天完成签到 ,获得积分10
1分钟前
人小鸭儿大完成签到 ,获得积分10
1分钟前
淡淡醉波wuliao完成签到 ,获得积分10
1分钟前
善学以致用应助优雅yu采纳,获得10
1分钟前
百里一江完成签到 ,获得积分10
1分钟前
WYnini完成签到 ,获得积分10
2分钟前
松松完成签到 ,获得积分10
2分钟前
毛毛弟完成签到 ,获得积分10
2分钟前
微生完成签到 ,获得积分10
2分钟前
HR112完成签到 ,获得积分10
2分钟前
自信放光芒~完成签到 ,获得积分10
2分钟前
卫卫完成签到 ,获得积分10
3分钟前
Struggle完成签到 ,获得积分10
3分钟前
lwtsy完成签到,获得积分10
3分钟前
David应助小慧采纳,获得10
3分钟前
陈皮完成签到 ,获得积分10
4分钟前
Ava应助科研通管家采纳,获得10
4分钟前
美好灵寒完成签到 ,获得积分10
4分钟前
小飞完成签到 ,获得积分10
4分钟前
玉鱼儿完成签到 ,获得积分10
4分钟前
澄子完成签到 ,获得积分10
4分钟前
Young完成签到 ,获得积分10
4分钟前
远离电刀完成签到,获得积分10
4分钟前
坦率的从波完成签到 ,获得积分10
4分钟前
涂涂完成签到 ,获得积分10
4分钟前
高分求助中
Востребованный временем 2500
Hopemont Capacity Assessment Interview manual and scoring guide 1000
Injection and Compression Molding Fundamentals 1000
Classics in Total Synthesis IV: New Targets, Strategies, Methods 1000
Mantids of the euro-mediterranean area 600
The Oxford Handbook of Educational Psychology 600
Mantodea of the World: Species Catalog Andrew M 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 内科学 物理 纳米技术 计算机科学 基因 遗传学 化学工程 复合材料 免疫学 物理化学 细胞生物学 催化作用 病理
热门帖子
关注 科研通微信公众号,转发送积分 3422947
求助须知:如何正确求助?哪些是违规求助? 3023304
关于积分的说明 8904088
捐赠科研通 2710762
什么是DOI,文献DOI怎么找? 1486669
科研通“疑难数据库(出版商)”最低求助积分说明 687143
邀请新用户注册赠送积分活动 682341