腹腔镜下卵巢子宫内膜异位囊肿剥除术后复发相关因素分析

目的:评估腹腔镜下卵巢子宫内膜异位囊肿剥除术后复发率及其影响因素。方法:回顾性分析本院1997年1月-2004年1月腹腔镜下卵巢子宫内膜异位囊肿剥除术266例的临床资料,通过术后随访3个月-7年,对影响卵巢囊肿复发率的相关因素进行分析。结果:Cox回归分析表明,子宫内膜异位症手术史和子宫内膜异位症AFS-r分期是影响卵巢子宫内膜异位囊肿剥除术后复发率的两个协变量(OR=0.276,P=0.001和OR=0.385,P=0.038)。Kaplan-Meier分析表明,7年累积复发率:子宫内膜异位症(内异症)手术史组65.25％,无内异症手术史组42.63％, 二者比较有显著性差异(P<0.01);内异症Ⅲ期组35.71％,内异症Ⅳ期组56.88％,二者比较有显著性差异(P<0.05)。结论:腹腔镜下卵巢子宫内膜异位囊肿剥除术是有效和可靠的,内异症手术史和AFS-r分期是影响术后复发率的2个明显因素。

Analysis of Relative Factors Influencing Recurrence of Endometriotic Cysts of Ovary after Cystectomy with Laparoscopy

Objective: To evaluate the relative factors that cause the recurrence of endometriotic cysts of ovary after cystectomy with laparoscopic. Methods: 266 patients who received excisions of endometriotic cysts in our hospital from January 1997 to January 2004 were investigated by means of regression analysis. All clinical data including three - month to seven - year follow - up reviews after surgery were analyzed. Results: The Cox Regression analysis showed previous surgery for endometriosis and stages AFS - r were two covariates that influenced recurrence of endometriotic cysts of ovary after cystectomy with laparoscopic. The Kaplan - Meier analysis showed, the cumulative rate of recurrence among the women with previous surgery for endometriosis before 7 years and that of the women without previous surgery for endometriosis were 65. 25% and 42. 63% , respectively , there was significant difference between two groups (P < 0. 01). The cumulative rate of recurrence in stage Ⅲ and stage Ⅳ was 35.71% and 56.88%, respectively, and there was difference(P<0, 05). Conclusions: The endometrial cystectomy with Laparoscopy seems to be effective and reliable way . Stage Ⅳ disease and previous surgery for endometriosis are two distinctly prognostic factors that influence the recurrence after surgery.