Long-term follow-up after ureteral reimplantation in patients with severe deep infiltrating endometriosis

Objective

To investigate the intraoperative features and long-term postoperative results of patients with ureteral endometriosis who underwent ureteral reimplantation.

Study design

In this retrospective study, we reviewed records of all patients with ureteral endometriosis treated by ureteral reimplantation. Pre-, intra- and post-operative information was collected.

Results

Of patients operated for endometriosis, seven were diagnosed with severe ureteral endometriosis and underwent ureteral reimplantation. Psoas hitch was the preferred technique for the ureteral reimplantation. During a mean postoperative follow up of 42.3 ± 20.0 months, all but one patient reported significant symptomatic improvement. None of the patients needed additional medical or surgical treatment and no recurrence was noted.

Conclusion

Ureteral reimplantation performed by a multidisciplinary surgical team is a suitable technique in selected cases, gives good long-term results and has no need for repeated surgical treatment.     

深部浸润型子宫内膜异位症手术患者的卫生经济学分析

目的:研究深部浸润型子宫内膜异位症手术治疗的住院费用、住院时间、术后住院时间及其影响因素。方法:通过查阅2000年1月至2009年12月在北京协和医院登记且经手术证实为深部浸润型子宫内膜异位症的病例,比较不同年龄(≤30岁,31～40岁,>40岁)、不同时期(2000～2004年,2005～2009年)、不同病理分型(单纯型,穹窿型和直肠型)、不同手术路径(开腹手术和腹腔镜手术)、不同手术方式(保守和根治/半根治手术)、合并其他类型内异症等不同因素类别的平均住院费用、平均住院时间和平均术后住院时间,分析这些因素对住院费用和住院时间的影响。结果:总计615例深部浸润型内异症患者纳入研究。深部浸润型内异症患者的平均住院费用显著高于其他内异症病例(8181元vs 7713元,P=0.009),但是平均年龄、平均住院时间和平均术后住院时间却显著小于其他内异症病例(分别为34.3岁vs 37.6岁,5.7天vs 6.3天以及3.7天vs 4.3天,P均<0.001)。在众多影响因素中,仅不同手术方式之间的平均住院费用有显著统计学差异(P<0.001),保守手术费用最低,根治性手术费用最高。平均住院时间和平均术后住院时间受到多种因素影响,多因素分析显示,手术路径、手术方式和病理分型的影响最大(P均<0.001),腹腔镜手术、保守手术和单纯型的平均住院时间最短,开腹手术、根治手术和直肠型的平均住院时间最长。结论:手术路径、手术方式和病理分型是影响深部浸润型内异症手术治疗所需住院费用和住院时间的最重要的因素。     

Vulvar endometriosis in surgical scar after excision of the Bartholin gland: report of a case

Endometriosis is a common gynecologic disease characterized by growth of endometrial glands and stroma outside the endometrium. Implants are most commonly found in the pelvis but can occur in many other sites. Vulvar involvement of endometriosis is extremely rare. A case of vulvar endometriosis is presented. Endometriosis was infiltrating the subcutaneous scar tissue of left labia minora after cystectomy of Bartholin gland for abscess that has recurred several times despite office-based treatment.     

Dienogest is as effective as triptorelin in the treatment of endometriosis after laparoscopic surgery: results of a prospective, multicenter, randomized study

OBJECTIVE: To compare the efficacy of Dienogest versus Decapeptyl at 3.75 mg as consolidation therapy for surgery in the treatment of endometriosis. DESIGN: Multicenter, open, randomized, parallel-group clinical trial. SETTING: Volunteer patients in an academic research environment. PATIENT(S): Women with grade 2, 3, and 4 (相似文献