Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution

Julie Maillot, Maillot J, Jean Luc Brun, Brun JL, Vincent Dubuisson, Dubuisson V, Marc Bazot, Bazot M, Grenier N, N. Grenier, Nicolas Grenier, F. Cornélis, François H Cornelis
European radiology · 2017 · vol. 27(10) , pp. 4298–4306 · doi:10.1007/s00330-017-4827-7 · PMID:28396995 · W2606605896
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-14 ⓘ

Percutaneous cryoablation of symptomatic abdominal wall endometriosis showed similar effectiveness to surgery alone but with shorter hospitalizations and fewer complications.

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This retrospective single-institution case-control study compared percutaneous image-guided cryoablation versus surgery alone for symptomatic abdominal wall endometriosis, enrolling 7 patients (15 treated lesions; local or general anesthesia) in the cryoablation group and 13 patients in the surgery group. Median follow-up was 22.5 months for cryoablation and 54 months for surgery, and outcomes included tolerance, procedure/hospitalization duration, complications, aesthetic sequelae, and symptom-free survival. Cryoablation required shorter procedure and hospitalization durations (41.5 minutes and 0.8 days) than surgery (73.5 minutes and 2.8 days), had no severe complications or aesthetic sequelae, and showed similar local symptom-free survival at 12 and 24 months (100% and 66.7% after cryoablation vs 92% at both time points after surgery, P = 0.45). A key limitation is the non-randomized design with different follow-up durations and small sample sizes. This paper is centrally about endometriosis—specifically symptomatic abdominal wall endometriosis treated with percutaneous cryoablation compared with surgery.

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Abstract

ObjectivesTo compare the outcomes of percutaneous image-guided cryoablation of symptomatic abdominal wall endometriosis (AWE) versus surgery alone.MethodsFrom 2004 to 2016, cryoablation or surgery alone was performed under local (n = 5) or general anaesthesia (n = 15) for AWE in a single institution in 7 (mean age, 36.1 years) and 13 (mean age, 31.9 years) patients, respectively. Fifteen lesions were treated by cryoablation (mean size, 2.3 cm; range, 0.5-7 cm) and 16 by surgery (2.5 cm; 1.1-3.4 cm). Tolerance, efficacy and patient and procedural characteristics were compared.ResultsMedian follow-up was 22.5 (range, 6-42) months after cryoablation and 54 (14-149) after surgery. The median procedure and hospitalisation durations were 41.5 min (24-66) and 0.8 days (0-1) after cryoablation, and 73.5 min (35-160) and 2.8 days (1-12 days) after surgery (both P = 0.01). Three patients (23.1%) had severe complications and nine aesthetic sequels (69.2%) after surgery, none after cryoablation (P = 0.05). The median 12- and 24-month symptom free-survival rates were 100% and 66.7% (95% CI, 5.4; 94.5) after cryoablation and 92% (55.3; 98.9) after surgery at both time points (P = 0.45).ConclusionsCryoablation presents similar effectiveness to surgery alone for local control of AWE while reducing hospitalisation duration and complications. Any aesthetic sequels were associated with the cryoablation treatment.Key points• Hospitalisation is shorter after cryoablation than after surgery of abdominal wall endometriosis. • A significantly lower rate of complications is observed after cryoablation compared to surgery. • Cryoablation of abdominal wall endometriosis presents similar effectiveness to surgery alone. • A significant reduction of pain is observed 6 months after treatment. • A significant reduction of abdominal wall endometriosis is observed at 6 months.
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Abstract

Objectives To compare the outcomes of percutaneous image-guided cryoablation of symptomatic abdominal wall endometriosis (AWE) versus surgery alone.

Methods

From 2004 to 2016, cryoablation or surgery alone was performed under local (n = 5) or general anaesthesia (n = 15) for AWE in a single institution in 7 (mean age, 36.1 years) and 13 (mean age, 31.9 years) patients, respectively. Fifteen lesions were treated by cryoablation (mean size, 2.3 cm; range, 0.5-7 cm) and 16 by surgery (2.5 cm; 1.1-3.4 cm). Tolerance, efficacy and patient and procedural characteristics were compared.

Results

Median follow-up was 22.5 (range, 6-42) months after cryoablation and 54 (14-149) after surgery. The median procedure and hospitalisation durations were 41.5 min (24-66) and 0.8 days (0-1) after cryoablation, and 73.5 min (35-160) and 2.8 days (1-12 days) after surgery (both P = 0.01). Three patients (23.1%) had severe complications and nine aesthetic sequels (69.2%) after surgery, none after cryoablation (P = 0.05). The median 12- and 24-month symptom free-survival rates were 100% and 66.7% (95% CI, 5.4; 94.5) after cryoablation and 92% (55.3; 98.9) after surgery at both time points (P = 0.45).

Conclusions

Cryoablation presents similar effectiveness to surgery alone for local control of AWE while reducing hospitalisation duration and complications. Any aesthetic sequels were associated with the cryoablation treatment. Key points • Hospitalisation is shorter after cryoablation than after surgery of abdominal wall endometriosis. • A significantly lower rate of complications is observed after cryoablation compared to surgery. • Cryoablation of abdominal wall endometriosis presents similar effectiveness to surgery alone. • A significant reduction of pain is observed 6 months after treatment. • A significant reduction of abdominal wall endometriosis is observed at 6 months. Similar content being viewed by others

References

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau for medical editorial services. Author information Authors and Affiliations Corresponding author Ethics declarations Guarantor The scientific guarantor of this publication is Francois Cornelis. Conflict of interest The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Funding The authors state that this work has not received any funding. Statistics and biometry No complex statistical methods were necessary for this paper. Informed consent Written informed consent was waived by the Institutional Review Board. Ethical approval Institutional Review Board approval was obtained. Study subjects or cohorts overlap Some study subjects or cohorts (n = 4) have been previously reported in Cornelis et al. [16]. Methodology • Retrospective • Case-control study • Performed at one institution Rights and permissions About this article Cite this article Maillot, J., Brun, J.L., Dubuisson, V. et al. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol 27, 4298–4306 (2017). https://doi.org/10.1007/s00330-017-4827-7 Received: Revised: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00330-017-4827-7

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endometriosis

MeSH descriptors

Abdominal Wall Abdominal Wall Abdominal Wall Cryosurgery Endometriosis Adult Cryosurgery Disease-Free Survival Endometriosis Female Humans Length of Stay Length of Stay Operative Time Postoperative Complications Retrospective Studies Young Adult

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