クマキリ ジユン
  熊切 順
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 原著
言語種別
査読の有無 査読あり
表題 Recurrence rate of endometriomas following a laparoscopic cystectomy.
掲載誌名 正式名:Acta obstetricia et gynecologica Scandinavica
略  称:Acta Obstet Gynecol Scand
ISSNコード:00016349/00016349
掲載区分国外
巻・号・頁 85(9),1120-4頁
著者・共著者 Kikuchi Iwaho, Takeuchi Hiroyuki, Kitade Mari, Shimanuki Hiroto, Kumakiri Jun, Kinoshita Katsuyuki
発行年月 2006
概要 BACKGROUND:The objectives were to observe the clinical course of patients who underwent laparoscopic cystectomy (LC) using transvaginal ultrasonography.METHOD:The definition of "recurrence" was to detect a diffuse, hypoechoic area whose long axis was at least 2 centimeters (cm) on the transvaginal ultrasonogram during the postoperative follow-up period. Using the Cox regression test, we analyzed each patient's background variables, namely, patient's age, the revised American Society of Reproductive Medicine score (r-ASRM score), use of gonadotropin releasing hormone analogues (GnRHa), and pregnancy during the observation period. Next, cyst size and multi-lobularity of each of the 417 cysts were also analyzed as recurrence risk factors per cyst.RESULTS:The mean postoperative observation period was 21.4+/-16.8 months. During the observation period, 50 (15.9%) out of 315 patients experienced recurrence and 51 (16.2%) out of 315 patients became pregnant. The cumulative recurrence rate per patient was 31.7% over 60 months. Among prognostic factors per patient, age and showed negative and r-ASRM scores positive correlations with cyst recurrence. On the other hand, we did not identify any cyst factors associated with recurrence. The patients who underwent hemilateral LC showed a 5.2% cyst recurrence rate in the ovary that appeared to be normal at the time of the initial surgery.CONCLUSION:Young age and severe endometriosis appeared to be the factors associated with high recurrence risk. Recurring ovarian endometrimas probably include cysts occurring spontaneously and those recurring from the cyst residues in the lesions where cystectomy has been performed.
DOI 10.1080/00016340600627154
PMID 16929419