Operative Therapie bei Endometriose

Zusammenfassung Die Endometriose wird invasiv durch Laparoskopie und bioptische Sicherung diagnostiziert, sodass es nahe liegt, dass sich die chirurgische Therapie in gleicher Narkose anschließt. Unterschiedliche Wachstumsformen der Endometriose einerseits und unterschiedliche mikroskopische und biochemische Charakteristika andererseits erfordern einen individuellen Behandlungsplan, der auch Alter der Patientin und reproduktive Erwartung berücksichtigt. Medikamentöse Therapieoptionen spielen hier additiv zum primär operativen Vorgehen eine Rolle, da oft symptomatische Maßnahmen bei dieser chronischen, rezidivierenden Krankheit ausreichen. Endoskopische Operationstechniken sind heute Standard. Unterschiede in Erfolgs- und Rezidivraten sind bisher für die verschiedenen Techniken nicht durch randomisierte Studien belegt. Abstract Usually endometriosis is diagnosed by invasive laparoscopy. It is reasonable to complete surgical removal of the disease and the adhesions during the same operation. Different types of endometriosis on the one hand and different morphological and biochemical characteristics on the other hand require different individual therapeutic strategies. The age of the patient and reproductive expectations also have to be taken into consideration. Medical treatment options play an additional role after surgery or instead of surgery. Because endometriosis is a chronic disease with a stage-related rate of recurrences, symptomatic treatment may suffice in some cases and may increase the recurrence-free intervals and reduce the number of operations. Endoscopic surgery is the gold standard today, but no differences in efficacy and recurrence rates have been scientifically proven for the different techniques. Similar content being viewed by others Literatur Adamson GD, Hurd SJ, Pasta DJ, Rodriguez BD (1993) Laparoscopic endometriosis treatment: is it better? 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