Analysis Of Recurrence Factors After Conservative Surgery For Ovarian Endometriosis

Objective: The clinical data and follow-up of 250 cases of patients with endometriosis was collected to explore the related factors of recurrence of endometriosis in patients after surgery.Methods : The patients from January 2012 to January 2015 with endometriosis treated in the Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and treated by operation were divided into two groups: recurrence group and recurrence group.The clinical data and follow-up data were collected and analyzed.SPSS 22 statistical software was used to analyze and process the data.Results:250 cases were followed up in the patients with endometriosis.There were 54 cases in the recurrent group.There were 196 cases in the no recurrent group.The recurrence rate was 21.6%.Univariate and multivariate statistical analysis of factors related to recurrence of endometriosis.Non conditional Logistic regression analysis showed that the menstrual period,r-AFS score,tenderness nodules of the posterior fornix,and surgical staging were positively correlated with the recurrence of patients with ovarian endometriosis(? >0,OR>1,P<0.05).The age of onset,postoperative drug therapy were inversely associated with recurrence in patients with endometriosis(?<0,OR<1,P<0.05).The positive rate and level of CA125 and CA199 were significantly higher in patients with stage III and IV than those in patients with I + IIand the difference was statistically significant(P<0.001).Conclusion:The incidence of ovarian endometriosis is high and the recurrence rate is very high which has a younger trend.The high recurrence rate is the difficulty of clinical treatment.The results of multiple regression analysis showed that the risk factors of recurrence in patients with EM were menstrual period,r-AFS score,tenderness nodules of the posterior fornix,and surgical staging.It is necessary to strengthen follow-up for patients with early onset younger age,long period of menstruation,posterior fornix nodules and late stage of surgery in order to intervene as soon as possible.We recommended EM patients after surgery to used medicine to treatment,according to individual factors.To the economic conditions permit,we recommended patients after surgery to continue giving GnRH-a to treatment and the best time was 6 months.Relatively GnRH-a had less side effect and better obvious effect.The level of CA125 and CA199 in endometriosis is related to clinical stage.The higher the clinical stage of EM patients was,the higher the positive rate and the level was.Combined CA125 and CA199 detection can improve the sensitivity of EM diagnosis.The level of CA125 and CA199 had some correlation with the risk of recurrence of EM and can be used as follow-up index.