A Comparative Study Of Long-term Management After Conservative Surgery For Ovarian Endometriosis

BackgroundEndometriosis is a common disease in women of childbearing age,and ovarian type is the most common of the four major types.The currently accepted treatment method is surgical removal of ovarian ectopic cysts,but due to the characteristics of the disease itself,there is a possibility of recurrence after surgery and the incidence is high.Although postoperative application of GnRh-a can effectively relieve pain and prevent recurrence,it cannot be used for a long time due to its many side effects.Therefore,what drugs are used in the short-term after GnRH-a after conservative surgery for ovarian endometriosis to achieve long-term management of the disease and improve the quality of life of patients is the focus of current research.ObjectiveTo explore and evaluate the therapeutic effects of GnRh-a and other drugs shortly after conservative surgery of ovarian endometriosis.MethodsUsing a two-way queue study design,a total of 96 patients withovarian endometriosis who were treated in the First Affiliated Hospital of Chongqing Medical University were selected.All patients were given conservative surgery.They were separated into four teams according to the different postoperative treatment methods.There were 23 patients in group A(GnRh-a was given after 3 cycles of treatment,and then oral contraceptives were given).There were 24 patients in group B(GnRh-a was given after 3 cycles of treatment,and then mirena was placed in the uterine cavity).There were 19 patients in group C(after 3 cycles of GnRh-a were given after surgery,and then etoposterene implant was implanted subcutaneously).There were 30 patients in group D(after 3 cycles of GnRh-a were given after surgery,and then no treatment was performed).The patients were followed up for one year,and the pain relief rate,recurrence rate,pregnancy rate,and adverse reactions of the four groups were evaluated.ResultsThe pain scores of the 6 and 12 months of the four groups of patients were visibly lower than those before the operation,and the difference was statistically significant(P<0.05).Postoperative recurrence rates in the four groups were 8.3%,8.7%,5.3% and 40%,respectively.The recurrence rates in groups A and C were visibly lower than those in group D,and the difference was statistically significant(P<0.0083).There was no statistically difference in the recurrence rate between group B and group D(P >0.0083).There was no statistically significant difference in pregnancy rates within one year after drug discontinuation between groups A and D(P> 0.05).ConclusionGnRh-a treatment after conservative surgery for moderate to severe ovarian endometriosis is far from enough,and its postoperative recurrence rate is extremely high and requires long-term management.Continued use of oral contraceptives or etoposterene implant can effectively relieve pain and reduce the recurrence rate within one year.The short-term postoperative GnRh-a treatment with etoposterene implant can significantly reduce the postoperative recurrence rate within one year.Its efficacy is equivalent to oral contraceptives,and it has the advantages of ease of use and high compliance.The treatment is very promising and worth promoting.Mirena's long-term efficacy in relieving pain and preventing relapse after conservative surgery for ovarian endometriosis needs further investigation.For patients who want a baby,pregnancy after stopping short-term GnRh-a treatment after giving birth control contraceptives does not reduce pregnancy rates within one year compared with those who become pregnant immediately after short-term GnRh-a treatment.