Clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist in treatment of endometriosis

Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist( GnRH-a) in the treatment of endometriosis( EMs). Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep. 2010 to Dec. 2010 were chosen and divided into three groups: control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy. The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments. Results The total effective rates of group A and group B( 84. 6%,86. 2%)were significantly higher than that of control group( 58. 3%),and the difference was statistically significant( P = 0. 032,P = 0. 032). The recurrence rates of group A and group B( 15. 4%,13. 8%) were significantly reduced compared with that of control group( 41. 6%)( P = 0. 012,P = 0. 012). The hormone levels decreased dramatically after treatment in three groups. The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant( P = 0. 001). Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis. The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate. For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.