Surgical and Percutaneous Image-Guided Therapies of Abdominal Wall Endometriosis: A Systematic Review of Current Evidence

Leo Razakamanantsoa, Léo Razakamanantsoa, Sylvain Bodard, Najdawi M, Milan Najdawi, Yohann Dabi, Sofiane Bendifallah, Bendifallah S, Cyril Touboul, Touboul C, Raphaël Lehrer, Lehrer R, Raphael Lehrer, Rémi Agbonon, Agbonon R, Remi Agbonon, Di Giuseppe R, Raphael Di Giuseppe, Matthias Barral, Barral M, Bazot M, Marc Bazot, Brun JL, Jean-Luc Brun, Horace Roman, Roman H, Clément Marcelin, Clement Marcelin, Marcelin C, Isabelle Thomassin‐Naggara, Thomassin-Naggara I, Isabelle Thomassin-Naggara, F. Cornélis, Francois H Cornelis
Journal of Minimally Invasive Gynecology · 2024 · vol. 31(9) , pp. 726–737.e2 · doi:10.1016/j.jmig.2024.06.007 · PMID:38901689 · W4399771357
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review synthesizes current evidence on surgical and percutaneous image-guided therapies for abdominal wall endometriosis, evaluating their efficacy and outcomes.

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Abstract

OBJECTIVE: Despite various surgical and nonsurgical strategies for abdominal wall endometriosis, the lack of definitive guidance on optimal treatment choice leads to clinical uncertainty. This review scrutinizes the safety and efficacy of abdominal wall endometriosis treatments to aid in decision-making. DATA SOURCES: We performed a systematic literature review of PubMed, Embase, and Cochrane Library databases from 1947 until December 2023. METHODS OF STUDY SELECTION: A comprehensive literature search identified studies that assessed both surgical and nonsurgical interventions, including high-intensity focused ultrasound (HIFU), cryoablation, radiofrequency ablation, and microwave ablation. This review is registered in NIHR-PROSPERO (CRD 42023494969). Local tumor control (LTC), local pain relief (LPR), and adverse events (AE) were recorded. TABULATION, INTEGRATION, AND RESULTS: This review included 51 articles among 831 identified. All study designs were considered eligible for inclusion. A total of 2674 patients are included: 2219 patients (83%) undergoing surgery, and 455 (17%) undergoing percutaneous interventions (342 HIFU, 103 cryoablation, 1 radiofrequency ablation, 9 microwave ablation). Follow-up length was 18 months in median, ranging from 1 to 235 months. Overall LTC rates ranged from 86% to 100%. Surgical interventions consistently demonstrated the highest rate of LTC with a median rate of 100%, and LPR with a median rate of 98.2% (95% confidence interval [CI]: 93.9-97.7). HIFU showed median LTC and LPR rates, respectively of 95.65% (95% CI, 87.7-99.9) and 76.1% (95% CI, 61.8-90.4); and cryoablation of 85.7% (95% CI, 66.0-99.9) and 79.2% (95% CI, 67.4-91.03). Minor AE was reported after surgery in 17.5% of patients (225/1284) including 15.9% (199/1284) of mesh implantation; 76.4% (239/313) after HIFU; and 8.7% (9/103) after cryoablation. Severe AE was reported in 25 patients in the surgery group and 1 in the percutaneous group. CONCLUSION: The safety profile and efficacy of nonsurgical interventions support their clinical utility for management of abdominal wall endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (70)

Cited by (7)

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