Combined Laparoscopy and Minilaparotomy in the Management of Stage III and IV Endometriosis with an Endometrioma

Yieh-Loong Tsai, Kok‐Min Seow, Jiann-Loung Hwang, Wei-Chi Cheng, Jesse Chuang
In: 輔仁醫學期刊 · 2004 · vol. 2(2) , pp. 55–61 · W2217658344
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This study evaluated the combined laparoscopy and minilaparotomy technique in 49 patients with stage III/IV endometriosis and endometrioma, finding a 51.2% pregnancy rate and a 4.7% recurrence rate over 36 months.

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Abstract

Background and Purpose: We attempted to assess the technique and pregnancy outcomes of combined laparoscopy and minilaparotomy for stage Ⅲ and Ⅳ endometriosis with an endometrioma. Methods: In total, 49 patients with Stage Ⅲ or Ⅳ endometriosis with an endometrioma were examined in this study. All patients received treatment with combined laparoscopy and minilaparotomy between August 1999 and July 2000. Preoperative ultrasonography was performed to diagnose the endometrioma and measure the tumor size. The serum CA-125 level was checked 1 week before surgery. Patients were then inspected for pregnancy outcome and disease recurrence over a 36-month follow-up period. Results: Six patients were lost to follow-up after surgery (12.2%). The mean age of the patients (n=43) was 30.3±4.2 years. The mean serumCA-125 level was 72.3±67.7 U/ml, and 74.4% of the tumors were larger than 3 cm in diameter. In total, 123 cycles of controlled ovarian hyperstimulation were performed during the follow-up period. The overall pregnancy rate was 51.2% The cumulative pregnancy rates at 12 and 24 months were 32.5% and 51.2%, respectively. The recurrence rate of endometriomas was 4.7%. Conclusion: Combined laparoscopy and minilaparotomy for the management of stage Ⅲ and Ⅳ endometriosis with an endometrioma are effective with a low recurrence rate, and there may be a similar conception rate compared with other surgical techniques over a 36-month follow-up period.

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endometriosisendometrioma

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