{"paper_id":"d6e1dd5d-d603-4bcd-a473-7b8a37745e70","body_text":"Zusammenfassung\nDie endoskopische Chirurgie hat zweifelsohne zu einer deutlichen Verbesserung der konservativen organerhaltenden Therapie der Endometriose geführt. Insbesondere bei der minimalen und milden Endometriose ist die Laparoskopie der Zugangsweg der Wahl. Auch moderate For-men der Endometriose mit einem einseitigem Endometriom oder mit begrenzten Verwachsungen sind der laparoskopischen Therapie gut zugänglich. Es besteht jedoch keine Einigkeit bezüglich des optimalen operativen Zugangsweges bei schweren Formen der Endometriose [7, 16]. Im Falle einer kompletten Obliteration des Douglasraumes, einer parametranen Infiltration bzw. eines übergreifens der Endometriose auf das hintere Scheidengewolbe oder bei bilateralen großen Endometriomen mit ausgedehnten Verwachsungen ist sowohl eine Laparoskopie als auch eine Laparotomie vertretbar.\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nLiteratur\nAdamson GD, Pasta DJ (1994) Surgical treatment of endometriosis-associated infertility: Meta-analysis compared with survival analysis. Am J Obstet Gynecol 171:1488–1505\nAdamson GD, Subak LL, Pasta DJ, Hurd SJ, von Franque O, Rodriguez BD (1992) Comparison of CO2-laser laparoscopy with laparotomy for treatment of endome-triomata. Fertil Steril 57:965–973\nAudebert AJM (1999) The role of microlaparoscopy for safer wall entry: incidence of umbilical adhesions according to past surgical history. Gynecol Endoscopy 8:363–367\nBateman BG, Kolp LA, Mills S (1994) Endoscopic versus laparotomy management of endometriomas. Fertil Steril 62:690–695\nBeretta P, Franchi M, Ghezzi F, Busacca M, Zupi E, Bolis P (1998) Randomized clinical trial of two laparoscopic treatments of endometriomas: cystectomy versus drainage and coagulation. Fertil Steril 70:1176–1180\nBusacca M, Marana R, Caruana, Candiani M (1999) Recurrence of ovarian endo-metrioma after laparoscopic excision. Am J Obstet Gynecol 18:519–523\nCandiani GB, Vercellini P, Fedele L, Roviaro GC, Rebuffat C, Trespidi L (1991) Conservative surgical treatment for severe endometriosis in infertile women: are we making progress? Obstet Gynecol Surv 46:490–498\nCandiani G, Fedele L, Vercellini P, Bianchi S, Di Nola G (1992) Presacral neurec-tomy for the treatment of pelvic pain associated with endometriosis: a controlled study. Am J Obstet Gynecol 167:100–103\nCanis M, Mage G (1993) Adhesion after resection of ovarian endometriomas. (Letter) Fertil Steril 59:934–935\nCanis M, Mage G, Wattiez A, Chapron C, Pouly JL, Bassil S (1992 b) Second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas. Fertil Steril 58:617–619\nCanis M, Pouly JL, Wattiez A, Manhes H, Mage G, Bruhat MA (1992 a) Incidence of bilateral adnexal disease in severe endometriosis: should a stage V be included in the AFS classification. Fertil Steril 57:691–692\nChapron C, Pierre P, Harchaoui Y, Lacroix S, Beguin S, Querleu D (1999) Gastrointestinal injuries during gynaecological laparoscopy. Hum Reprod 14:333–337\nChapron C, Jacobs S, Dubuisson JB, Vieira M, Liaras E, Fauconnier A (2001) Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum. Acta Obstet Gynecol Scand 80:349–354\nChatman DL, Zbella EA (1986) Pelvic peritoneal defects and endometriosis: further observations. Fertil Steril 46:711–714\nCook AS, Rock JA (1991) The role of laparoscopy in the treatment of endometriosis. Fertil Steril 55:663–680\nCrosignani PG, Vercellini P (1995) Conservative surgery for severe endometriosis: should laparotomy be abandoned definitively? Hum Reprod 10:2412–2418\nCrosignani PG, Costantini W, Vercellini P, Cortesi I, Biffignandi F, Imparato E (1996) Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 66:706–711\nCullen TS (1914) Adenomyoma of the rectovaginal septum. JAMA 62:835–839\nDavidson JM, Park W, Penney LL (1993) Comparative study of operative laparoscopy versus laparotomy. Analysis of the financial impact J Reprod Med 38:357–360\nDogan MM, Ugur M, Soysal SK (1996) Transvaginal sonographic diagnosis of ovarian endometrioma. Int J Gynaecol Obstet 52:145–149\nDonnez J, Nisolle M, Casanas F (1993) Endoscopic surgery. Bailliere’s Clin Obstet Gynaecol 7:839–848\nDonnez J, Nisolle M, Gillerot S (1994) Ovarian endometrial cyst: the role of gona-dotrophin-releasing hormone agonist and/or drainage. Fertil Steril 62:63–66\nDonnez J, Nisolle M, Gillet N (1996) Large ovarian endometriomas. Hum Reprod 11:641–646\nDonnez J, Nisolle M, Gillerot S, Smets M, Bassil S, Casanas-Roux F (1997) Recto-vaginal septum adenomyotic nodules: a series of 500 cases. B J Obstet Gynaecol 104:1014–1018\nFarquhar C, Sutton C (1998) The evidence of the management of endometriosis. Curr Opin Obstet Gynecol 10:321–332\nFayez JA, Dempsey RA (1992) Short hospital stay for gynaecologic reconstructive surgery via laparotomy. Obstet Gynecol 81:598–600\nGant NF (1992) Infertility and endometriosis: comparison of pregnancy outcomes with laparotomy versus laparoscopic techniques. Am J Obstet Gynecol 166:1072–1081\nGarry R, Clayton R, Hawe J (2000) The effect of endometriosis: radical laparoscopic excision on quality of life indicators. Br J Obstet Gynecol 107:44–54\nGomel VG (1989) Operative laparoscopy: time for acceptance. Fertil Steril 52:1–11\nGrimes DA (1992) Frontiers of operative laparoscopy: a review and critique of the evidence. Am J Obstet Gynecol 166:1062–1071\nHughes EG, Fedorkow DM, Collins JA (1993) A quantitative overview of controlled trials in endometriosis associated infertility. Fertil Steril 59:963–970\nJansen RP, Russel P (1986) Nonpigmented endometriosis: clinical, laparoscopic, and pathological definition. Am J Obstet Gynecol 155:1154–1159\nJones KD, Sutton CJ (2000) Laparoscopic management of ovarian endometriomas: a critical review of current practice. Curr Opin Obstet Gynecol 12:309–315\nKoninckx PR, Martin D (1992) Deep endometriosis: a consequence of infiltrating or retraction or possibly adynomyosis externa? Fertil Steril 58:924–928\nLevrant SG, Bieber EJ, Barnes RB (1997) Anterior abdominal wall adhesions after laparotomy or laparoscopy. J Am Assoc Gynecol Laparosc 4:353–356\nMalik E, Berg C, Meyhofer-Malik A, Buchweitz O, Moubayed P, Diedrich K (2000) Fluorescence diagnosis of endometriosis using 5-aminolevulinic acid. Surg Endosc 14:452–455\nMarana R, Constantini W, Muzzii L, Uglietti A, Caruana P, Arnold M (1994) Laparoscopic excision of ovarian endometriomas: Does post-operative treatment prevent recurrence? J Am Assoc Gynecol Laparoscop 4:20\nMartin DC, Hubert GD, Levy BS (1989) Depth of infiltration of endometriosis. J Gynecol Surg 5:55–60\nMilingos S, Loutradis D, Kallipolitis G, Liapi A, Drakakis P, Antsaklis A, Michalas S (1999) Comparison of laparoscopy with laparotomy for the treatment of extensive endometriosis with large endometriomata. J Gynecol Surg 15:131–136\nMurphy AA, Green WR, Bobbie D, dela Cruz ZC, Rock JA (1986) Unsuspected endometriosis documented by scanning electron microscopy in visually normal peritoneum. Fertil Steril 46:522–524\nNezhat C, Nezhat F, Pennigton E (1992) Laparoscopic treatment of infiltrative rec-tosigmoid colon and rectovaginal septum endometriosis by the technique of vi-deolaparoscopy and the CO2-laser. Br J Obstet Gynaecol 99:664–667\nPossover M, Diebolder H, Plaul K, Schneider A (2000) Laparoscopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96:304–307\nRedwine DB (1991) Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease. Fertil Steril 56:628–634\nRedwine DB (1999) Ovarian endometriosis. A marker for more severe pelvic and intestinal disease. Fertil Steril 73:310–315\nRedwine DB, Wright JT (2001) Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril 76:358–365\nReich H, McGlynn F, Salvat J (1991) Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. J Reprod Med 36:516–522\nSaleh A, Tulandi T (1999) Reoperation after laparoscopic treatment of endome-triomas by exzision and fenestration. Fertil Steril 72:322–324\nSawada T, Ohara S, Kawakami S (1999) Laparoscopic surgery vs. laparotomy management for infertile patients with ovarian endmetrioma. Gynecological Endo-scopy 8:17–19\nSutton CJG, Ewen SP, Jacobs SA, Whitelaw N (1996) Laser laparoscopic surgery in the treatment of ovarian endometriomas. J Am Assoc Gynecol Laparosc 4:319–323\nTadir Y, Fisch B (1993) Operative laparoscopy: a challenge for general gynaecology? Am J Obstet Gynecol 169:7–12\nThe American Fertility Society (1985) Revised American Fertility Society classifycation of endometriosis. Fertil Steril 43:351–352\nVasquez G, Cornillie F, Brosens IA (1984) Peritoneal endometriosis: scanning electron microscopy and histology of minimal pelvic endometriotic lesions. Fertil Steril 42:696–703\nVercellini P, Fedele L, Bianchi S, Candiani G (1991) Pelvic Denervation for chronic pain associated with endometriosis: fact or fancy? Am J Gynecol 165:745–749\nVercellini P, Vendola N, Bocciolone L, Colombo A, Rognoni MT, Bolis G (1992) Laparoscopic aspiration of ovarian endometriomas. Effect with postoperative gonadotropin releasing hormone agonist treatment. J Reprod Med 37:577–582\nWheeler JM, Malinak LR (1987) Recurrent endometriosis. Contrib Gynecol Obstet 16:13–21\nWilson ML, Farquhar CM, Sinclair OJ, Johnson MP (2000) Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea (Cochrane Review). In: The Cochrane Library, Issue 1, Update Software, Oxford\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2002 Springer-Verlag Berlin Heidelberg\nAbout this chapter\nCite this chapter\nBuchweitz, O., Malik, E. (2002). Die chirurgische Therapie der moderaten und der schweren Endometriose. In: Malik, E., Diedrich, K. (eds) Gynäkologische Endoskopie pro und contra. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57440-5_5\nDownload citation\nDOI: https://doi.org/10.1007/978-3-642-57440-5_5\nPublisher Name: Steinkopff, Heidelberg\nPrint ISBN: 978-3-642-63264-8\nOnline ISBN: 978-3-642-57440-5\neBook Packages: Springer Book Archive","source_license":"CC0","license_restricted":false}