The value of preoperative GnRH analogue treatment for stage IV endometriosis with laparoscopic conservative surgery

Objective To evaluate the clinical significance of laparoscopic surgery for stage Ⅳ endometriosis following GnRH agonist (GnRH-a) treatment.Methods Fifty-eight patients with endometriosis graded stage IV according to the scoring system of the revised American Fertility Association ( r-AFS), underwent laparoscpic surgery. Laparscopic surgery were performded in 28 patients of group A to peel off the cysts and separate adhesion. Sameoperation was performed in another 30 patients in Group B in additional to 3 months of preoperative triptorelin(GnRH-a)therapy. The triptorelin in a close of 3.75 milligrams was administered by mensal intramuscular injection for 3 months.Results Significant difference was found in total operative time[(118±23)min vs (79±26)min] and blood loss[(400±55)ml vs (180±60)ml]between the group A and group B.During the 2-5 years following-up of their pregnancy rates(25% vs 46.7%), recurrence rates(32.1% vs 10.0%) and pelvic pain reduction rates(42.8% vs 70.0%) were also different significantly between the two groups.Conclusion GnRH-a treatment before laparosopic surgery for the endometriosis in stage Ⅳ seems to offer any advantage in terms of subsequent surgical performance and improving the curative effects of the surgery.