Derin İnfiltratif Endometrioziste Preoperatif Değerlendirme
Synopsis
Peritonu 5 mm veya daha fazla derine penetrasyon yapan veya çevre dokulara yayılabilen derin infiltratif endometriozis, endometriozisin agresif formudur. Yerleşim yerine bağlı olarak pelvik ağrı, infertilite, gastrointestinal ağrı gibi semptomlara sebep olabilir. DIE nin cerrahi tedavisi zaman alıcı, pahalı ve risklidir. İyi bir preoperatif değerlendirmeyle kapsamlı bir cerrahi planlama yapılmalıdır. ENZIAN skorlama sistemi DIE nin anatomisini daha iyi anlamak için oluşturulmuştur. TVU, MR gibi radyolojik görüntüleme metodları preoperatif değerlendirme için uygundur. Bu radyolojik görüntüleme yöntemleri endometriotik lezyonların tipi, yerleşimi ve yayılımı ile ilgili öngürü sağlar. DIE semptomlarına dayalı özgüllüğü ve duyarlılığı yüksek puanlama sistemiyle ilgili yayınlanmış çalışmalar da vardır.
Deep infiltrative endometriosis, which penetrates 5 mm and more into the peritoneum or can spread to surrounding tissues, is the aggressive form of endometriosis. İt may cause like pelvic pain, infertility, dyspareunia , gastrointestinal pain depending on localization. Surgical approach of DIE is time consuming, expensive and risky. A comprehensive surgical planning should be made with a good preoperative evaluation. ENZIAN score was created for a clear understanding of anatomy of DIE. Radiological imaging methods such as TVUSG and MRI are available for preoperative evaluation. This can radiological imaging methods make predictions about the type, localization and extent of endometriotic lesions. There is studies about score system which has high sensitivity and specificity based on symptoms of DIE have also been published,too.
References
Smolarz B, Szyłło K, Romanowicz H. Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int J Mol Sci. 2021 Sep 29;22(19):10554. doi: 10.3390/ijms221910554. PMID: 34638893; PMCID: PMC8508982
Capezzuoli T.,Clemenza S.,Sorbi F.,Campana D.,Vannuccini S.,Chapron C.,et al. Classification/staging systems for endometriosis: the state of the art., GREM Gynecological and Reproductive Endocrinology & Metabolism (2020); 01/2020:14-22 doi: 10.53260/grem.201014
Murphy AA. Clinical aspects of endometriosis. Ann N Y Acad Sci. 2002 Mar;955:1-10; discussion 34-6, 396-406. doi: 10.1111/j.1749-6632.2002.tb02760.x. PMID: 11949938
Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E; ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005 Oct;20(10):2698-704. doi: 10.1093/humrep/dei135. Epub 2005 Jun 24. PMID: 15980014
Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019 Nov;15(11):666-682. doi: 10.1038/s41574-019-0245-z. Epub 2019 Sep 5. PMID: 31488888
Daraï E, Cohen J, Ballester M. Colorectal endometriosis and fertility. Eur J Obstet Gynecol Reprod Biol. 2017 Feb;209:86-94. doi: 10.1016/j.ejogrb.2016.05.024. Epub 2016 Jun 9. PMID: 27342685.
Montanari E, Dauser B, Keckstein J, Kirchner E, Nemeth Z, Hudelist G. Association between disease extent and pain symptoms in patients with deep infiltrating endometriosis. Reprod Biomed Online. 2019 Nov;39(5):845-851. doi: 10.1016/j.rbmo.2019.06.006. Epub 2019 Jun 19. PMID: 31378689
Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, Buchweitz O, Greb R, Kandolf O, Mangold R, Masetti W, Neis K, Rauter G, Reeka N, Richter O, Schindler AE, Sillem M, Terruhn V, Tinneberg HR. ENZIAN-Score, eine Klassifikation der tief infiltrierenden Endometriose [ENZIAN-score, a classification of deep infiltrating endometriosis]. Zentralbl Gynakol. 2005 Oct;127(5):275-81. German. doi: 10.1055/s-2005-836904. PMID: 16195969.
Gruppo Italiano per lo Studio dell'Endometriosi. Relationship between stage, site and morphological characteristics of pelvic endometriosis and pain. Hum Reprod. 2001 Dec;16(12):2668-71. doi: 10.1093/humrep/16.12.2668. PMID: 11726593
Haas D, Shebl O, Shamiyeh A, Oppelt P. The rASRM score and the Enzian classification for endometriosis: their strengths and weaknesses. Acta Obstet Gynecol Scand. 2013 Jan;92(1):3-7. doi: 10.1111/aogs.12026. Epub 2012 Nov 5. PMID: 23061819.
Di Paola V, Manfredi R, Castelli F, Negrelli R, Mehrabi S, PozziMR. Detection and localization of deep endometriosis by meansof MRI and correlation with the ENZIAN score. Eur J Radiol.2015;84:568-574.8
Montanari E, Dauser B, Keckstein J, Kirchner E, Nemeth Z, HudelistG. Association between disease extent and pain symptoms in pa-tients with deep infiltrating endometriosis. Reprod Biomed Online.2019;39:845-851.9.
Burla L, Scheiner D, Samartzis EP, et al. The ENZIAN score as a pre-operative MRI-based classification instrument for deep infiltratingendometriosis. Arch Gynecol Obstet. 2019;300:109-116
Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Bréart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril. 2002 Oct;78(4):719-26. doi: 10.1016/s0015-0282(02)03331-9. PMID: 12372446
Bailey HR, Ott MT, Hartendorp P. Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum. 1994 Aug;37(8):747-53. doi: 10.1007/BF02050136. PMID: 8055717
Zanelotti A, Decherney AH. Surgery and Endometriosis. Clin Obstet Gynecol. 2017 Sep;60(3):477-484. doi: 10.1097/GRF.0000000000000291. PMID: 28742580; PMCID: PMC5635831
Kondo W, Bourdel N, Tamburro S, Cavoli D, Jardon K, Rabischong B, Botchorishvili R, Pouly J, Mage G, Canis M. Complications after surgery for deeply infiltrating pelvic endometriosis. BJOG. 2011 Feb;118(3):292-8. doi: 10.1111/j.1471-0528.2010.02774.x. Epub 2010 Nov 18. PMID: 21083863
Chapron C, Santulli P, de Ziegler D, Noel JC, Anaf V, Streuli I, Foulot H, Souza C, Borghese B. Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis. Hum Reprod. 2012 Mar;27(3):702-11. doi: 10.1093/humrep/der462. Epub 2012 Jan 16. PMID: 22252082
Fraser MA, Agarwal S, Chen I, Singh SS. Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: a retrospective review. Abdom Imaging. 2015 Mar;40(3):587-94. doi: 10.1007/s00261-014-0243-5. PMID: 25236953; PMCID: PMC4325192.)
Menakaya U, Reid S, Lu C, Gerges B, Infante F, Condous G. Performance of ultrasound-based endometriosis staging system (UBESS) for predicting level of complexity of laparoscopic surgery for endometriosis. Ultrasound Obstet Gynecol. 2016 Dec;48(6):786-795. doi: 10.1002/uog.15858. Erratum in: Ultrasound Obstet Gynecol. 2017 May;49(5):667. doi: 10.1002/uog.17479. PMID: 26764187
Shannon Reid, George Condous, Update on the ultrasound diagnosis of deep pelvic endometriosis, European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 209, 2017,Pages 50-54,ISSN 0301 2115,https://doi.org/10.1016/j.ejogrb.2016.02.040.
de Oliveira JGA, Bonfada V, Zanella JFP, Coser J. Transvaginal ultrasound in deep endometriosis: pictorial essay. Radiol Bras. 2019 Sep-Oct;52(5):337-341. doi: 10.1590/0100-3984.2018.0019. PMID: 31656353; PMCID: PMC6808616.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016 Feb 26;2(2):CD009591. doi: 10.1002/14651858.CD009591.pub2. PMID: 26919512; PMCID: PMC7100540.
Medeiros LR, Rosa MI, Silva BR, Reis ME, Simon CS, Dondossola ER, da Cunha Filho JS. Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015 Mar;291(3):611-21. doi: 10.1007/s00404-014-3470-7. Epub 2014 Oct 7. PMID: 25288268
Kataoka ML, Togashi K, Yamaoka T, Koyama T, Ueda H, Kobayashi H, Rahman M, Higuchi T, Fujii S. Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology. 2005 Mar;234(3):815-23. doi: 10.1148/radiol.2343031366. Epub 2005 Jan 21. PMID: 15665220
Bianek-Bodzak A, Szurowska E, Sawicki S, Liro M. The importance and perspective of magnetic resonance imaging in the evaluation of endometriosis. Biomed Res Int. 2013;2013:436589. doi: 10.1155/2013/436589. Epub 2013 Nov 20. PMID: 24350271; PMCID: PMC3854449
Lorusso, F., Scioscia, M., Rubini, D. et al. Magnetic resonance imaging for deep infiltrating endometriosis: current concepts, imaging technique and key findings. Insights Imaging 12, 105 (2021). https://doi.org/10.1186/s13244-021-01054-x
Bazot M, Malzy P, Cortez A, Roseau G, Amouyal P, Daraï E. Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol. 2007 Dec;30(7):994-1001. doi: 10.1002/uog.4070. PMID: 17992706
Lafay Pillet MC, Huchon C, Santulli P, Borghese B, Chapron C, Fauconnier A. A clinical score can predict associated deep infiltrating endometriosis before surgery for an endometrioma. Hum Reprod. 2014 Aug;29(8):1666-76. doi: 10.1093/humrep/deu128. Epub 2014 Jun 4. PMID: 24903201
Capezzuoli T.,Clemenza S.,Sorbi F.,Campana D.,Vannuccini S.,Chapron C.,et al. Classification/staging systems for endometriosis: the state of the art., GREM Gynecological and Reproductive Endocrinology & Metabolism (2020); 01/2020:14-22 doi: 10.53260/grem.201014
Murphy AA. Clinical aspects of endometriosis. Ann N Y Acad Sci. 2002 Mar;955:1-10; discussion 34-6, 396-406. doi: 10.1111/j.1749-6632.2002.tb02760.x. PMID: 11949938
Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E; ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005 Oct;20(10):2698-704. doi: 10.1093/humrep/dei135. Epub 2005 Jun 24. PMID: 15980014
Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019 Nov;15(11):666-682. doi: 10.1038/s41574-019-0245-z. Epub 2019 Sep 5. PMID: 31488888
Daraï E, Cohen J, Ballester M. Colorectal endometriosis and fertility. Eur J Obstet Gynecol Reprod Biol. 2017 Feb;209:86-94. doi: 10.1016/j.ejogrb.2016.05.024. Epub 2016 Jun 9. PMID: 27342685.
Montanari E, Dauser B, Keckstein J, Kirchner E, Nemeth Z, Hudelist G. Association between disease extent and pain symptoms in patients with deep infiltrating endometriosis. Reprod Biomed Online. 2019 Nov;39(5):845-851. doi: 10.1016/j.rbmo.2019.06.006. Epub 2019 Jun 19. PMID: 31378689
Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, Buchweitz O, Greb R, Kandolf O, Mangold R, Masetti W, Neis K, Rauter G, Reeka N, Richter O, Schindler AE, Sillem M, Terruhn V, Tinneberg HR. ENZIAN-Score, eine Klassifikation der tief infiltrierenden Endometriose [ENZIAN-score, a classification of deep infiltrating endometriosis]. Zentralbl Gynakol. 2005 Oct;127(5):275-81. German. doi: 10.1055/s-2005-836904. PMID: 16195969.
Gruppo Italiano per lo Studio dell'Endometriosi. Relationship between stage, site and morphological characteristics of pelvic endometriosis and pain. Hum Reprod. 2001 Dec;16(12):2668-71. doi: 10.1093/humrep/16.12.2668. PMID: 11726593
Haas D, Shebl O, Shamiyeh A, Oppelt P. The rASRM score and the Enzian classification for endometriosis: their strengths and weaknesses. Acta Obstet Gynecol Scand. 2013 Jan;92(1):3-7. doi: 10.1111/aogs.12026. Epub 2012 Nov 5. PMID: 23061819.
Di Paola V, Manfredi R, Castelli F, Negrelli R, Mehrabi S, PozziMR. Detection and localization of deep endometriosis by meansof MRI and correlation with the ENZIAN score. Eur J Radiol.2015;84:568-574.8
Montanari E, Dauser B, Keckstein J, Kirchner E, Nemeth Z, HudelistG. Association between disease extent and pain symptoms in pa-tients with deep infiltrating endometriosis. Reprod Biomed Online.2019;39:845-851.9.
Burla L, Scheiner D, Samartzis EP, et al. The ENZIAN score as a pre-operative MRI-based classification instrument for deep infiltratingendometriosis. Arch Gynecol Obstet. 2019;300:109-116
Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Bréart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril. 2002 Oct;78(4):719-26. doi: 10.1016/s0015-0282(02)03331-9. PMID: 12372446
Bailey HR, Ott MT, Hartendorp P. Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum. 1994 Aug;37(8):747-53. doi: 10.1007/BF02050136. PMID: 8055717
Zanelotti A, Decherney AH. Surgery and Endometriosis. Clin Obstet Gynecol. 2017 Sep;60(3):477-484. doi: 10.1097/GRF.0000000000000291. PMID: 28742580; PMCID: PMC5635831
Kondo W, Bourdel N, Tamburro S, Cavoli D, Jardon K, Rabischong B, Botchorishvili R, Pouly J, Mage G, Canis M. Complications after surgery for deeply infiltrating pelvic endometriosis. BJOG. 2011 Feb;118(3):292-8. doi: 10.1111/j.1471-0528.2010.02774.x. Epub 2010 Nov 18. PMID: 21083863
Chapron C, Santulli P, de Ziegler D, Noel JC, Anaf V, Streuli I, Foulot H, Souza C, Borghese B. Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis. Hum Reprod. 2012 Mar;27(3):702-11. doi: 10.1093/humrep/der462. Epub 2012 Jan 16. PMID: 22252082
Fraser MA, Agarwal S, Chen I, Singh SS. Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: a retrospective review. Abdom Imaging. 2015 Mar;40(3):587-94. doi: 10.1007/s00261-014-0243-5. PMID: 25236953; PMCID: PMC4325192.)
Menakaya U, Reid S, Lu C, Gerges B, Infante F, Condous G. Performance of ultrasound-based endometriosis staging system (UBESS) for predicting level of complexity of laparoscopic surgery for endometriosis. Ultrasound Obstet Gynecol. 2016 Dec;48(6):786-795. doi: 10.1002/uog.15858. Erratum in: Ultrasound Obstet Gynecol. 2017 May;49(5):667. doi: 10.1002/uog.17479. PMID: 26764187
Shannon Reid, George Condous, Update on the ultrasound diagnosis of deep pelvic endometriosis, European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 209, 2017,Pages 50-54,ISSN 0301 2115,https://doi.org/10.1016/j.ejogrb.2016.02.040.
de Oliveira JGA, Bonfada V, Zanella JFP, Coser J. Transvaginal ultrasound in deep endometriosis: pictorial essay. Radiol Bras. 2019 Sep-Oct;52(5):337-341. doi: 10.1590/0100-3984.2018.0019. PMID: 31656353; PMCID: PMC6808616.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016 Feb 26;2(2):CD009591. doi: 10.1002/14651858.CD009591.pub2. PMID: 26919512; PMCID: PMC7100540.
Medeiros LR, Rosa MI, Silva BR, Reis ME, Simon CS, Dondossola ER, da Cunha Filho JS. Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015 Mar;291(3):611-21. doi: 10.1007/s00404-014-3470-7. Epub 2014 Oct 7. PMID: 25288268
Kataoka ML, Togashi K, Yamaoka T, Koyama T, Ueda H, Kobayashi H, Rahman M, Higuchi T, Fujii S. Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology. 2005 Mar;234(3):815-23. doi: 10.1148/radiol.2343031366. Epub 2005 Jan 21. PMID: 15665220
Bianek-Bodzak A, Szurowska E, Sawicki S, Liro M. The importance and perspective of magnetic resonance imaging in the evaluation of endometriosis. Biomed Res Int. 2013;2013:436589. doi: 10.1155/2013/436589. Epub 2013 Nov 20. PMID: 24350271; PMCID: PMC3854449
Lorusso, F., Scioscia, M., Rubini, D. et al. Magnetic resonance imaging for deep infiltrating endometriosis: current concepts, imaging technique and key findings. Insights Imaging 12, 105 (2021). https://doi.org/10.1186/s13244-021-01054-x
Bazot M, Malzy P, Cortez A, Roseau G, Amouyal P, Daraï E. Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol. 2007 Dec;30(7):994-1001. doi: 10.1002/uog.4070. PMID: 17992706
Lafay Pillet MC, Huchon C, Santulli P, Borghese B, Chapron C, Fauconnier A. A clinical score can predict associated deep infiltrating endometriosis before surgery for an endometrioma. Hum Reprod. 2014 Aug;29(8):1666-76. doi: 10.1093/humrep/deu128. Epub 2014 Jun 4. PMID: 24903201
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Published
January 21, 2025
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