Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation

Kim, Miseon; Kim, Joo Myoung; Seong, Seok Ju; Lee, Soo Yoon; Han, Myoungseok; Cho, Yeon Jean

doi:10.1016/j.ajog.2013.11.007

Cited by 29 publications

(23 citation statements)

References 25 publications

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“…A recorrência dos endometriomas ovarianos após tratamento videolaparoscópico ainda permanece elevada 22 e sua prevenção incerta porque a patogênese da recidiva ainda é desconhecida 23 . Vários autores defendem que os tratamentos clínico e cirúrgico adequados minimizam o dano ovariano, amenizam os sintomas da doença e, possivelmente, reduzem a recidiva da lesão 12,24,25 .…”

Section: Discussionunclassified

Fatores preditores de recorrência do endometrioma ovariano após tratamento laparoscópico

Carvalho

Pereira

Martins

et al. 2015

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Analisar os fatores que possam influenciar na recorrência do endometrioma ovariano após tratamento videolaparoscópico. MÉTODOS: Estudo de coorte retrospectivo. Foram avaliadas 129 pacientes submetidas à videolaparoscopia, entre 2003 e 2012, para tratamento de endometrioma ovariano, com seguimento pós-operatório mínimo de 2 anos. Foi realizada ultrassonografia transvaginal para excluir persistência da lesão e identificação de recidiva. Para comparação de variáveis contínuas foi utilizado o teste t de Student, e para o teste de homogeneidade entre as proporções, o teste do χ 2 ou exato de Fisher (para frequências menores do que cinco). Para a obtenção de fatores prognósticos ligados à recidiva foi aplicado o modelo de regressão linear multivariado. O nível de significância utilizado para a análise foi de 5%. RESULTADOS: A taxa de recorrência foi de 18.6%. O tamanho do endometrioma, a modalidade cirúrgica empregada e os dados demográficos como idade, índice de massa corpórea, presença de sintomas, tabagismo e prática de exercícios físicos não se associaram ao aumento da recorrência. Foi observado que a interrupção do tratamento clínico pós-operatório apresentou risco significativo para aumento da recorrência (OR 23,7; IC95% 5,05; p=0,001). CONCLUSÃO: O uso contínuo de contracepção oral parece reduzir dramaticamente a taxa de recidiva de endometrioma ovariano. Neste estudo, a interrupção do tratamento foi o fator associado com maior taxa de recidiva da lesão após o tratamento videolaparoscópico. Abstract PURPOSE:To analyze the factors that might influence the recurrence of ovarian endometriomas after laparoscopic excision. METHODS: A retrospective cohort study. We evaluated 129 patients who underwent laparoscopic excision of ovarian endometriomas from 2003 to 2012 and who were followed up for at least two years after surgery. Vaginal ultrasound was repeated to exclude persistent lesion and to identify recurrence. The Student's t-test was used to compare continuous variables and the χ 2 or Fischer exact test (for values of less than five) was used to test homogeneity between proportions. A logistic regression model for multivariate proportional hazards was used to analyze predictors of long-term outcome. The level of significance was set at 5% in all analyses. RESULTS: The overall rate of ovarian endometrioma recurrence was 18.6%. Endometrioma diameter, surgical procedure techniques and demographic data such as age, presenting symptoms, body mass index, smoking and physical exercise habits were not associated with recurrence, whereas interruption of postoperative medical treatment was significantly correlated with a higher recurrence rate (OR 23.7; p=0.001). CONCLUSION: Current oral contraceptive use appears to be associated with a dramatic reduction in the risk of recurrence of ovarian endometriotic cysts. Treatment interruption was associated with a higher recurrence rate of ovarian endometrioma after laparoscopic treatment.

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Section: Discussionunclassified

Fatores preditores de recorrência do endometrioma ovariano após tratamento laparoscópico

Carvalho

Pereira

Martins

et al. 2015

Rev. Bras. Ginecol. Obstet.

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“…Two recent clinical studies demonstrated that dienogest effectively reduced endometriosis lesions and improved quality of life . However, dienogest should be taken every day and reported adverse reactions included headache, acne and nausea . The levonorgestrel‐releasing intrauterine system (LNG‐IUS) might be a suitable medical device for maintenance therapy.…”

Section: Introductionmentioning

confidence: 99%

“…2 Postoperative medical therapies are required to decrease treatment failures after surgery. 3,4 They included oral contraceptives, progestin and gonadotropin-releasing hormone agonists (GnRHa). 5,6 However, the long-term recurrence rates exceed 40%.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the efficacy of diegnogest and levonorgestrel‐releasing intrauterine system after laparoscopic surgery for endometriosis

Lee

Jung

Song

et al. 2018

J of Obstet and Gynaecol

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“…2 Postoperative medical therapies have been considered to reduce surgical treatment failures. [3][4][5] Current postoperative hormonal treatments include gonadotropin-releasing hormone agonists (GnRHas), progestin, and combined oral contraceptives (OC). [6][7][8][9] However, endometriosisassociated pain symptoms usually return after the cessation of postoperative hormonal therapy.…”

mentioning

confidence: 99%

Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study

Chen

Hsu

Huang

et al. 2017

American Journal of Obstetrics and Gynecology

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Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation

Cited by 29 publications

References 25 publications

Fatores preditores de recorrência do endometrioma ovariano após tratamento laparoscópico

Fatores preditores de recorrência do endometrioma ovariano após tratamento laparoscópico

Comparison of the efficacy of diegnogest and levonorgestrel‐releasing intrauterine system after laparoscopic surgery for endometriosis

Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study

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