Abstract

LOPEZ C, Nayara et al. Recidivas de endometriomas ováricos tras cirugía laparoscópica. Rev. chil. obstet. ginecol. [online]. 2011, vol.76, n.6, pp. 380-388. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262011000600002.

Objective: To analyze the variables influencing recurrence after laparoscopic excision of ovarian endome-trioma. Methods: We retrospectively studied 214 cases who underwent laparoscopic surgery between 2005 and 2006 in the Hospital La Paz and followed for 5 years. As recurrence criteria were considered: pain, ultrasound finding and Ca125 elevation. Results: 30.8% (66/214) of patients presented pain recurrence, 28% (60/214) ultrasound recurrence and 16.8% (36/214) Ca 125 elevation. Patients with symptomatic recurrence had a bigger degree of dysmenorrhea and dyspareunia before surgery (6.8 ± 2.5 and 1.3 ± 2.5 against 3.8 ± 3.4 and 0.2 ± 1.0 in no recurrence ones (p=0.0001; p=0.0001). Previous dysmenorrheal and dyspareunia punctuation was also greater in ultrasound recurrences (5.9 ± 3.3 and 1.2 ± 2.5 against 4.3 ± 3.4 and 0.2 ± 1.1 of those with no recurrence) (p=0.003; p=0.002). Dysmenorrhea recurrence was greater in young (31.3 ± 5.4 years old versus 34.3 ± 7.8; p=0.02), with cystectomy (35% versus 16.7% in adnexectomy; p=0.02), adhesiolysis (46.4% versus 23.4%; p=0.001) and with medical treatment after surgery (41.5% against 22.5%; p=0.004). The mean time of no symptomatic recurrence was 44 months (CI95%:41-47) and the no ultrasound recurrence was 47 months (CI95%:45-50). Conclusion: The degree of dysmenorrhea and dyspareunia before surgery was the factor most clearly associated with recurrence.

Keywords : Recurrence; pain; endometrioma; laparoscope.