Efficacy of Laparoscopic Surgery Combined with Gonadotropin-Releasing Hormone Agonist in Patients with Endometriosis

Objective:To evaluate the effectiveness of laparoscopic surgery combined with gonadotropin-releasing hormone agonist(GnRHa)for endometriosis(EMs).Methods:The clinical datum of 98 women with EMs who were treated from Sep2007to Dec 2010 were retrospectively analyzed.All patients were divided into GnRHa group(n=64)and control group(n=34)after laparoscopic surgery.The patients in GnRHa group were administered by GnRHa injection(3.75 mg)at the fifth day,once every 28 days,for three times.GnRHa group was divided into two subgroups.Diphereline subgroup(n=33)after laparoscopic surgery was given injection of Diphereline only.Patients in add back therapy subgroup(n=31)were given injection of Diphereline only for 1 month and then given Premarin 0.3 mg and progestin 2.0mg at the same time.All the patients were followed up for 12 months after surgery to evaluate the therapeutic effect.Cure rate,remission rate,invalid rate or recurrence rate in three groups were observed.The side reactions of Diphereline subgroup and add back therapy subgroup were observed.Results:In Diphereline subgroup and add back therapy subgroup,cure rate,remission rate and invalid rate or recurrence rate were 57.6%,36.3%, 6.1%and 58.1%,32.2%,9.7%,respectively.There was no significant difference between the two subgroups(P0.05). However,in the two subgroups,cure rate(38.2%)and remission rate(17.7%)were higher than those in control group,while recurrence rate(44.1%)was lower than that in control group,and there were significant differences(P0.05).The rate of side reactions was higher in Diphereline subgroup than that in add back therapy subgroup(P0.05).Conclusions:After laparoscopic surgery,combination with GnRHa for EMs can improve the cure rate and reduce the recurrence rate.From the second month,combined with add back therapy can reduce the rate of side reactions of GnRHa.