Wann und wie großzügig diagnostische Laparoskopie?

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This paper clarifies the indications for diagnostic laparoscopy in endometriosis management by reviewing guidelines, incidence, pathogenesis, and alternatives, and presenting a clinical practice algorithm.

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The paper discusses when and why diagnostic laparoscopy is indicated, focusing on endometriosis. Using a narrative approach, it reviews relevant guidelines and considers how incidence and pathogenesis, along with available diagnostic and therapeutic alternatives, inform the decision. It then proposes a clinical-practice algorithm that frames “when” laparoscopic diagnosis should be pursued. A limitation is that the article is not presented as original comparative research but rather as a synthesis intended to clarify indications. Relevance to endometriosis: the title and abstract state that laparoscopy has a key role in diagnosing and treating endometriosis and the paper’s goal is specifically to determine appropriate indication for diagnostic laparoscopy in endometriosis.

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Abstract

Laparoscopy holds a key role in daignosing and treating endometriosis. The present paper aims at clarifying the correct indication for this procedure. To this end, relevant guidelines as well as considerations regarding incidence, pathogenesis as well as diagnostic and therapeutic alternatives are presented. An algorithm for clinical practice is presented.
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Subscribe to RSS DOI: 10.1055/s-2005-836890 © Georg Thieme Verlag Stuttgart · New York Wann und wie großzügig diagnostische Laparoskopie? Diagnostic Laparoscopy - when and why?Publication History Publication Date: 29 September 2005 (online) Zusammenfassung Die Laparoskopie nimmt eine zentrale Stellung in der Diagnostik und Therapie der Endometriose ein. Die vorliegende Arbeit soll einen Beitrag zur Klärung leisten, wann der Eingriff indiziert ist. Dazu werden die einschlägigen Leitlinien sowie Überlegungen zur Inzidenz und Pathogenese, zu diagnostischen und therapeutischen Alternativen vorgestellt und ein Algorithmus für die klinische Praxis entwickelt. Abstract Laparoscopy holds a key role in daignosing and treating endometriosis. The present paper aims at clarifying the correct indication for this procedure. To this end, relevant guidelines as well as considerations regarding incidence, pathogenesis as well as diagnostic and therapeutic alternatives are presented. An algorithm for clinical practice is presented. Schlüsselwörter Endometriose - Laparoskopie - diagnostischer Algorithmus Key words Endometriosis - laparoscopy - diagnostic algorithm Literatur - 1 Abbott J A, Hawe J, Clayton R D, Garry R. The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up. Hum Reprod. 2003; 18 1922-1927 - 2 Bedaiwy M A, Falcone T. Laboratory testing for endometriosis. Clin Chim Acta. 2004; 340 41-56 - 3 Ballweg M L. The Endometriosis Sourcebook. Contemporary Books, Chicago 1995 - 4 Capelo F O, Kumar A, Steinkampf M P, Azziz R. Laparoscopic evaluation following failure to achieve pregnancy after ovulation induction with clomiphene citrate. Fertil Steril. 2003; 80 1450-1453 - 5 Clinical Green Top Guidelines. The Investigation and Management of Endometriosis. www.rcog.org.uk - 6 Dmowski W P, Lesniewicz R, Rana N, Pepping P, Noursalehi M. Changing trends in the diagnosis of endometriosis: a comparative study of women with pelvic endometriosis presenting with chronic pelvic pain or infertility. Fertil Steril. 1997; 67 238-243 - 7 Evers J L. The second-look laparoscopy for evaluation of the result of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil Steril. 1987; 47 502-504 - 8 Hadfield R, Mardon H, Barlow D, Kennedy S. Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod. 1996; 11 878-880 - 9 Harkki-Siren P, Sjoberg J, Kurki T. Major complications of laparoscopy: a follow-up Finnish study. Obstet Gynecol. 1999; 94 94-98 - 10 Hornstein M D, Gleason R E, Orav J, Haas S T, Friedman A J, Rein M S, Hill J A, Barbieri R L. The reproducibility of the revised American Fertility Society classification of endometriosis. Fertil Steril. 1993; 59 1015-1021 - 11 Jacobson T Z, Barlow D H, Koninckx P R, Olive D, Farquhar C. Laparoscopic surgery for subfertility associated with endometriosis (Cochrane Review). In: The Cochrane Library, Ausg. 1. John Wiley & Sons Ltd., Chichester 2005 - 12 Moen M H, Muus K M. Endometriosis in pregnant and non-pregnant women at tubal sterilization. Hum Reprod. 1991; 6 699-702 - 13 Moore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol. 2002; 20 630-634 - 14 Neis K J. AG Gynäkologische Endoskopie; AGO; DGGG . Leitlinie zur laparoskopischen Operation von Ovarialtumoren. Frauenarzt. 2004; 45 681-687 - 15 Pagidas K, Falcone T, Hemmings R, Miron P. Comparison of reoperation for moderate (stage III) and severe (stage IV) endometriosis-related infertility with in vitro fertilization-embryo transfer. Fertil Steril. 1996; 65 791-795 - 16 Sillem M, Teichmann A T. Patientinnenzentrierte Aspekte der Endometriose. Gynäkologe. 2003; 36 41-52 - 17 Sutton C JG, Pooley S, Ewen S P, Haines P. Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with mild to moderate endometriosis. Fertil Steril. 1997; 68 1070-1074 - 18 Stratton P, Winkel C, Premkumar A, Chow C, Wilson J, Hearns-Stokes R, Heo S, Merino M, Nieman L K. Diagnostic accuracy of laparoscopy, magnetic resonance imaging, and histopathologic examination for the detection of endometriosis. Fertil Steril. 2003; 79 1078-1085 - 19 The Norwegian Society of Gynecology and Obstetrics .Clinical Guidelines in General Gynecology 1997. The Norwegian Medical Association, Lysaker 1997 - 20 Ulrich U. AG Gynäkologische Endoskopie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe; Stiftung Endometrioseforschung .Empfehlungen zur Diagnostik und Therapie der Endometriose. Zur Publikation eingereicht - 21 Vercellini P, Crosignani P G. Epidemiology of endometriosis. In: Brosens I, Donnez J. The current status of endometriosis - research and management. Parthenon, Carnforth, Pearl River 1992 - 22 Witz C A, Burns W N. Endometriosis and infertility: is there a cause and effect relationship?. Gynecol Obstet Invest. 2002; 53 (Suppl 1) 2-11 PD Dr. M. Sillem Abteilung für Gynäkologie und Geburtshilfe · DRK Krankenhaus Neuwied Marktstraße 104 56564 Neuwied Email: [email protected]

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Algorithms Endometriosis Endometriosis Female Germany Germany Humans Laparoscopy

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