Combined ultrasonographically guided drainage and laparoscopic excision of large endometriomas: a pilot study

G. G. Garzetti, Giuseppe Gioele Garzetti, Garzetti GG, A Ciavattini, Andrea Ciavattini, Mauro Tiriduzzi, M Tiriduzzi, Tiriduzzi M
Gynecologic and obstetric investigation · 1998 · vol. 45(4) , pp. 266–268 · doi:10.1159/000009981 · PMID:9623794 · W2067479858
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This prospective pilot study demonstrated that pre-operative GnRH analogue treatment followed by ultrasonographically guided drainage and laparoscopic excision is a feasible approach for large ovarian endometriomas.

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Abstract

We report a prospective pilot study which evaluated the feasibility of combined ultrasonographically guided drainage and laparoscopic excision after pre-operative administration of a gonadotrophin-releasing hormone analogue for 3 months in the management of ovarian endometriotic cysts >5 cm. Ten patients with an ultrasonographic diagnosis of large unilateral or bilateral ovarian endometriotic cysts received an intramuscular injection of leuprorelinum acetate 3.75 every 4 weeks for 12 weeks. After 4 weeks of medical treatment, the endometrioma was carefully drained transabdominally under ultrasonographic control. Within 8 weeks since the last injection, the patients were submitted to a second ultrasonography, and laparoscopy-guided stripping of the endometrioma was performed. A videotape review was undertaken to evaluate duration and complexity of the different phases of surgery. Stripping of endometriomas with preservation of residual ovarian parenchymas was obtained in all cases; adhesiolysis was complete in 6 cases. There were neither intra-operative complications nor conversions in laparotomy. In conclusion, gonadotrophin-releasing hormone analogue and cyst drainage seem to permit an easy laparoscopic approach of large endometriomas; the findings of our pilot phase seem to justify a randomized trial to better define the effectiveness of this approach with respect to standard procedures.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Drainage Endometriosis Endometriosis Laparoscopy Laparoscopy Adult Adult Drainage Drainage Endometriosis Endometriosis Feasibility Studies Feasibility Studies Female Female Humans Humans Leuprolide Leuprolide Leuprolide

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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Cited by (8)

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