| Objective: The general clinical data of 501 cases of abdominal endometriosis were retrospectively analyzed,and the clinical characteristics of abdominal endometriosis were discussed,and the related clinical characteristics of abdominal endometriosis were deeply understood.The clinical factors related to recurrent and non-recurrent abdominal endometriosis patients were compared and analyzed,and the risk factors related to recurrent abdominal endometriosis were further studied to provide clinical basis for reducing the recurrence of abdominal endometriosis in the future.Methods: A total of 501 patients with abdominal endometriosis admitted to the Department of Gynecology of Affiliated Hospital of Jining Medical University of Shandong Province from January 2016 to July 2022 were included.General clinical data were analyzed,including age,clinical symptoms and signs,gestational time,caesarean section time,CA125,imaging examination,surgical bleeding volume,operation time,lesion diameter,postoperative pathology,etc.Secondly,the clinical characteristics and differences of each group were compared according to the number of endometriosis lesions(single type and multiple type),the penetration and depth of endometriosis lesions(subcutaneous fatty type,sheath type and peritoneal type),and the number of cesarean section(single and multiple cesarean section).The patients were followed up for at least 12 months after the operation,and were divided into relapse type and non-recurrence type according to the postoperative recurrence,and the clinical correlation factors between the two groups were compared.Results:1.The onset age of 501 patients with abdominal endometriosis was16.50-51.75 years old,with an average onset age of(30.92±4.98)years.The incubation period was 3.00-173.00 months,and the average incubation period was(38.39±28.22)months.The maximum lesion diameter was about 0.50-10.00 cm,and the average lesion size was about(2.38±1.10)cm.In 41 cases(8.18%),the median maximum diameter of the lesions was 3.50 cm.2.Among 501 patients with abdominal wall endometriosis,437(87.23%)cases were single type and 64(12.77%)cases were multiple type.Compared with single type of abdominal wall endometriosis,multiple type of abdominal wall endometriosis had earlier onset age(P=0.012),shorter incubation period(P=0.008),longer operation time(P<0.001),more blood loss(P<0.001),and longer hospital stay(P=0.003).There were 56 cases(12.81%)of subcutaneous fatty type,331cases(75.74%)of sheath fatty type and 50 cases(11.44%)of peritoneal fatty type in single onset,and 5 cases(7.81%)of subcutaneous fatty type,44 cases(68.75%)of sheath fatty type and 15 cases(23.44%)of peritoneal fatty type in multiple onset(P=0.021).There are more patients with multiple types of peritoneal abdominal wall endometriosis.The mean value of serum CA125 was 24.54±18.79U/m L in patients with single abdominal wall endometriosis and 50.01±31.24U/m L in patients with multiple abdominal wall endometriosis.The serum CA125 value of patients with multiple abdominal wall endometriosis was higher than that of patients with single abdominal wall endometriosis(P=0.004).3.According to the depth of bottom invasion of endometriosis detected during the operation,61 cases(12.18%)were subcutaneous fatty type,375 cases(74.85%)were sheath type,and 65 cases(12.97%)were peritoneal type.Compared with the other two types,Lower body mass index(P=0.012),more cesarean sections(P=0.045),longer operation time(P<0.001),more intraoperative blood loss(P<0.001),longer hospital stay(P<0.001),larger maximum diameter of lesions(P<0.001),mesh placement rate(P<0.001)and multiple lesions rate(P=0.021)high.4.In imaging examination,32 patients with abdominal endometriosis underwent surgery,magnetic resonance and ultrasound examination of superficial masses at the same time.In surgical exploration,4(12.50%)cases of subcutaneous lipidosis,23(71.88%)cases of sheath type,and7(21.88%)cases of peritoneum type.In MRI examination,4(12.50%)cases of subcutaneous lipidosis,23(71.88%)cases of sheath type,5(15.62%)cases of peritoneal type.In ultrasound examination,10(31.25%)cases were subcutaneous lipidosis,21(65.62%)cases were sheath lipidosis,and 1(3.12%)cases were peritoneal lipidosis.Compared with Mr Examination,Mr Examination and surgical exploration had higher consistency in the classification of lesions(P=0.661).5.A total of 398 patients with abdominal wall endometriosis were followed up,of which 34 cases recurred,accounting for 8.54%,and the median recurrence time was 16.00(3.00-65.00)months.Compared with the non-recurrent group(n=364)and the recurrent group(n=34),the recurrent group had more cesarean sections(P=0.016),longer operation time(P=0.023),more intraoperative blood loss(P=0.017),and more peritoneal lesions(P=0.004).The association between the number of cesarean delivery,as well as other covariates,and recurrence was shown according to univariate regression analysis.The number of cesarean section,the duration of operation,and the amount of intraoperative bleeding were positively correlated with the recurrence of abdominal wall endometriosis(P<0.05).According to the results of univariate correlation analysis,after adjusting the confounding factors such as age of onset,body mass index,gravidity,parity,and lesion type,multiple linear regression analysis showed that the number of cesarean section before onset was an independent risk factor for recurrence of abdominal wall endometriosis(OR=2.95,95%CI: 1.14-7.62,P=0.026).Conclusion:1.Abdominal endometriosis usually occurs in women of childbearing age with a history of cesarean section.The incubation period is3.00-173.00 months,and the maximum diameter of the lesions is about0.50-10.00 cm,among which the median maximum diameter of the lesions with mesh placement is about 3.50 cm.2.According to the number and type of heterogeneous lesions observed during intraoperative exploration,compared with single-type abdominal endometriosis,multi-type patients had earlier onset age,shorter incubation period,longer operation time,more surgical bleeding,longer hospital stay,and more peritoneal type patients.CA125 test has a certain significance for the number of abnormity in abdominal wall.3.According to intraoperative exploration and classification of base invasion and depth of heterogeneous lesions,the peritoneal type was the most common in the three groups,accounting for 375(74.85%)cases.Compared with subcutaneous fat and sheath type,peritoneal type had lower body mass index,more cesarean section,larger intraoperative blood loss,longer operation time and hospital stay,larger maximum diameter of the lesions,higher rate of placement of patches and multiple lesions.4.In imaging examination,compared with ultrasound examination and magnetic resonance examination,magnetic resonance examination and surgical exploration have higher consistency in the classification of lesions.5.A total of 398 patients with abdominal endometriosis were followed up,of which 34(8.54%)had recurrence,and the median recurrence time was 16.00(3.00-65.00)months.Compared with non-recurrent type,recurrent type had more cesarean sections,longer operation time,more surgical bleeding and more peritoneal lesions.The number of cesarean sections,duration of operation and amount of blood loss are risk factors for postoperative recurrence of abdominal endometriosis,and the number of cesarean sections is an independent risk factor for recurrent abdominal endometriosis. |
PDF Full Text Request