Clinical analysis of the cause of repeated resection for patients with abdominal wall endometriosis

Objective To investigate the clinical characteristics of cases undergoing repeated resection in patients with abdominal wall endometriosis (AWE).Methods Retrospective analyses were performed in 101 patients with abdominal wall endometriosis who were hospitalized in Department of Obstetrics and Gynecology of Peking Union Medical College Hospital between 1992 and 2005.According to their surgical histories, the patients were divided into two groups,repeated resection group (n=5) and non-repeated resection group (n=96).Results In repeated resection group,there was 1 patient with repeated recurrent AWE,which had become an atypical endometriosis gradually;the lesion resected in the second surgery was on the opposite side of the first surgery in 1 patient who had a menses-related pain at the same site,and was supposed to be a missed diagnosis;lesions were resected with healthy tissues 0.5 cm beside their outer margin in the other three patients.The mean size of masses detected by palpations and ultrasound scan was significantly larger in repeated resection group than that in non-repeated resection group (P 0.05 ).However,there was no significant difference in the excision sample dimensions between the two groups.It maybe due to the healthy tissues resected in the repeated resections that were less than those in the first surgery.Conclusion To avoid missing smaller lesions,it is important to explore the suspicious sites with caution according to patients' preoperative symptoms during the surgery.If possible,it is recommended to resect the lesions with healthy tissues 1 cm or more than it beside their outer margins.Of the long-term repeated recurrent AWE, malignant changes should be considered.