Clinical practice guidelines for the treatment of extragenital endometriosis in Japan, 2018

Abstract

The aim of this publication is to disseminate the clinical practice guidelines for the treatment of intestinal, bladder/ureteral, thoracic and umbilical endometriosis, already published in Japanese, to non-Japanese speakers. For developing the original Japanese guidelines, the clinical practice guideline committee was formed by the research team for extragenital endometriosis, which is part of the research program of intractable disease of the Japanese Ministry of Health, Labor and Welfare. The clinical practice guideline committee formulated eight clinical questions for the treatment of extragenital endometriosis, which were intestinal, bladder/ureteral, thoracic and umbilical endometriosis. The committee performed a systematic review of the literature to provide responses to clinical questions and developed clinical guidelines for extragenital endometriosis, according to the process proposed by the Medical Information Network Distribution Service. The recommendation level was determined using modified Delphi methods. The clinical practice guidelines were officially approved by the Japan Society of Obstetrics and Gynecology and the Japan Society of Endometriosis. This English version was translated from the Japanese version.

Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

“…Hirata et al [17] suggested guidelines for management of extragenital endometriosis and claims for umbilical endometriosis that radical surgery with wide local excision represents the primary treatment. Surgical excision is strongly recommended but with weak supporting evidence because of unknown long-term efficacy and complications.…”

Small Bowel Obstruction Caused by Ileal Endometriosis with Appendiceal and Lymph Node Involvement Treated with Single-Incision Laparoscopic Surgery: A Case Report and Review of the Literature

“…In principle, ectopic endometrial tissues should be surgically removed to cure the disease [ 18 ]. Recently published guidelines developed by the Japan Society of Obstetrics and Gynecology and the Japan Society of Endometriosis indicate that surgical intervention can ease symptomatic intestinal endometriosis of the ileocecal region, small intestine, and appendix [ 19 ]. However, no reports have compared surgical treatment with nonsurgical treatments, suggesting that surgical treatment is recommended as an option when nonsurgical treatments fail.…”

Endometrioza ombilicală

“…În pofida faptului că până la ora actuală nu există nici un studiu comparativ al medicației terapeutice și tratamentului chirurgical al EO, majoritatea autorilor consideră intervenția chirurgicală drept tratament de bază [5,12,18,19,21,32,36,40,42]. Până în prezent nu există un management standardizat în abordarea EO [5, 16,32,40,[43][44][45]. Prin urmare, există mai multe terapii hormonale utilizate pentru ameliorarea durerii asociate endometriozei: contraceptive orale, progestative și antiprogestative, agoniștii GnRH (hormon eliberator de gonadotropinã) [2, 5, 7, 16,32,40,[43][44][45].…”