Abstract
Objective In vitro studies demonstrated that implantation on membranes (peritoneum, amniotic membranes) can take place if there are defects on the surface of the membranes. If these mechanisms play a role for the development of endometriosis in vivo, then patients with surgical treatment of peritoneal endometriosis in the luteal phase must have a high recurrence rate.
Design Retrospective analysis of operation charts and follow-up data.
Setting Department of gynecology, in a hospital-based endometriosis treatment center.
PATIENT(S): Two hundred twenty premenopausal women.
INTERVENTION(S): Laparoscopic treatment for peritoneal endometriosis, stage I and II by revised American Society for Reproductive Medicine guidelines.
MAIN OUTCOME MEASURE(S): During the follow-up period of 2 years, symptoms and gynecological and sonographic findings were documented. In case of suspected recurrence a repeat laparoscopy with biopsy was performed to prove the recurrent endometriosis macroscopically and histologically.
RESULT(S): The total recurrence rate after 2 years was 9.6%. The recurrence rate of group III (15%) was twice as high as those of group I (7%) and group II (8%), as indicated by subjective complaints, clinical findings, macroscopy, and histology; no differences were found between groups I and II.
CONCLUSION(S): Endoscopic surgery for the treatment of peritoneal endometriosis should not be performed in the luteal phase.
endometriosis surgery timing menstrual cycle recurrence, laparoscopic treatment peritoneal endometriosis luteal phase, peritoneal defects endometriosis implantation theory, endometriosis recurrence rate surgical timing, Schweppe endometriosis endoscopic surgery menstrual phase, peritoneal endometriosis stage I II laparoscopic treatment outcomes, luteal phase surgery endometriosis recurrence retrospective, endometriosis recurrence prevention surgical planning, retrograde menstruation implantation peritoneal defects, optimal timing endometriosis surgery follicular vs luteal phase
PMID 12372453 12372453 DOI 10.1016/s0015-0282(02)03431-3 10.1016/s0015-0282(02)03431-3
Keywords
Biopsy, Endometriosis/pathology/surgery, Female, Follicular Phase, Humans, Laparoscopy, Luteal Phase, Menstrual Cycle, Ovulation, Peritoneal Diseases/pathology/surgery, Premenopause, Recurrence, Reoperation, Retrospective Studies, Time Factors, Treatment Outcome