Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study

Amparo Garcia-Tejedor, Amparo García‐Tejedor, Jose M Martinez-Garcia, José Manuel Martínez, Candas B, Beatriz Candas, Suarez E, Elena Suarez, Laura Mañalich, Mañalich L, L. Mañalich, Maria Gomez, Gomez M, M.L. Gómez, Elisabet Merino, Merino E, Marta Castellarnau, Castellarnau M, Purificacion Regueiro, Regueiro P, Carreras M, Manuel Carreras, Eva Martinez-Franco, Eva Martínez Franco, Marta Carrarrach, Carrarrach M, Subirats N, Neus Subirats, Barbera J, Judith Barbera, Santiago Gonzalez, Santiago González, Gonzalez S, Climent M, Maite Climent, Eulalia Fernández-Montolí, Maria-Eulalia Fernández-Montolí, Fernández-Montolí E, Jordi Ponce
Journal of Minimally Invasive Gynecology · 2020 · vol. 27(5) , pp. 1133–1140 · doi:10.1016/j.jmig.2019.08.036 · PMID:32272240 · W3015733305
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This pilot study prospectively compared ethanol sclerotherapy to laparoscopic surgery for treating endometriomas across multiple centers.

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Abstract

Study objectiveTo compare the cost-effectiveness of ultrasound (US)-guided aspiration and ethanol sclerotherapy versus laparoscopic surgery for benign-appearing ovarian endometrioma.DesignProspective, cohort pilot study.SettingMultiple centers, Spain.PatientsForty patients with suspected ovarian endometrioma identified by US, with a maximum diameter of 35 to 100 mm, of whom 33 met inclusion criteria.InterventionsThe study group (n = 17) underwent US-guided aspiration plus sclerotherapy with ethanol, and the control group (n = 14) underwent laparoscopic cystectomy.Measurements and main resultsRecurrence, complications, and direct costs were compared. One of 17 sclerotherapy patients recurred (5.9%) compared with 4 of 14 laparoscopic surgery patients (28.6%) (odds ratio 0.18, 0.01-1.53). No serious adverse effects (Clavien-Dindo ≥ III) were observed in the sclerotherapy group; 1 patient in the surgery group had a Clavien-Dindo IIIb complication. Median hospital direct costs were significantly lower in the sclerotherapy group than those in the surgery group-266 euros versus 2189 euros.ConclusionEthanol sclerotherapy seems to be cost-effective for endometrioma and also appears to reduce complications. In this pilot study, recurrence was not higher than with conventional surgery.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ethanol Laparoscopy Ovarian Diseases Sclerotherapy Adolescent Adult Biopsy, Needle Biopsy, Needle Biopsy, Needle Biopsy, Needle Case-Control Studies Cohort Studies Cost-Benefit Analysis Endometriosis Endometriosis Endometriosis Ethanol Female Humans

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