Derin İnfiltrasyonlu Endometriozis (DİE) ve Ağır Pelvik Ağrısı Olan Hastada Cerrahi Her Zaman En İyi Tedavi Yöntemi midir?
Özet
Derin infiltratif endometriozis(DİE), kadınların çoğunda şiddetli ağrı ile seyreden klinik bir tablodur. Cerrahi eksizyonun ve tıbbi tedavinin derin endometriozisle ilişkili ağrı semptomlarını iyileştirmede benzer şekilde etkili olduğunu gösterilmiştir. Cerrahi müdahalede cerrahi deneyim, olgunun karmaşıklığı ve anatomik yerleşim yerleri gibi faktörlerle doğrudan ilişkilidir. Hastanın yaşam kalitesini iyileştirmek ve tekrar ameliyat oranını azaltmak için ilaç tedavisinin kullanımı tartışılmalıdır. Sonuç olarak üst düzey endometriozis merkezinde DİE'nin cerrahi tedavisinin, hastaların çoğunda semptomları, birçok vakada uzun bir süre iyileştirdiğini gösterilmiştir.
Deep infiltrative endometriosis (DIE) is a clinical condition that presents with severe pain in most women. Surgical excision and medical treatment have been shown to be similarly effective in improving the pain symptoms associated with deep endometriosis. Surgical intervention is directly related to factors such as surgical experience, complexity of the case, and anatomical location. The use of drug therapy should be discussed to improve the patient's quality of life and reduce the rate of reoperation. In conclusion, it has been shown in a high-level endometriosis center that surgical treatment of DIE improves symptoms in most patients, and in many cases for a long period of time.
Referanslar
Johnson NP, Hummelshoj L, Consortium WESM, Abrao M, Adamson G, Allaire C, et al. Consensus on current management of endometriosis. Human reproduction. 2013;28(6):1552-68.
Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020;382(13):1244-56.
D’Alterio MN, D’Ancona G, Raslan M, Tinelli R, Daniilidis A, Angioni S. Management challenges of deep infiltrating endometriosis. International journal of fertility & sterility. 2021;15(2):88.
Martire FG, Giorgi M, D’Abate C, Colombi I, Ginetti A, Cannoni A, et al. Deep infiltrating endometriosis in adolescence: early diagnosis and possible Prevention of Disease Progression. Journal of Clinical Medicine. 2024;13(2):550.
Symons LK, Miller JE, Kay VR, Marks RM, Liblik K, Koti M, et al. The immunopathophysiology of endometriosis. Trends in molecular medicine. 2018;24(9):748-62.
Shigesi N, Kvaskoff M, Kirtley S, Feng Q, Fang H, Knight JC, et al. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Human reproduction update. 2019;25(4):486-503.
Tal A, Tal R, Pluchino N, Taylor HS. Endometrial cells contribute to preexisting endometriosis lesions in a mouse model of retrograde menstruation. Biology of reproduction. 2019;100(6):1453-60.
Wang Y, Nicholes K, Shih I-M. The origin and pathogenesis of endometriosis. Annual Review of Pathology: Mechanisms of Disease. 2020;15(1):71-95.
Signorile PG, Viceconte R, Baldi A. New insights in pathogenesis of endometriosis. Frontiers in medicine. 2022;9:879015.
JA S. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into peritoneal cavity. Am J Obstet Gynecol. 1927;14:422-69.
Jerman LF, Hey-Cunningham AJ. The role of the lymphatic system in endometriosis: a comprehensive review of the literature. Biology of reproduction. 2015;92(3):64, 1-10.
Nukaly HY, Dalloul R, Kayali A, Nassar J, Asiry S. Endometrioma Unveiled: A Comprehensive Review of the Pathogenesis, Diagnosis, and Current Management Strategies of Ovarian Endometriosis. Authorea Preprints. 2023.
Maruyama T. A revised stem cell theory for the pathogenesis of endometriosis. Journal of Personalized Medicine. 2022;12(2):216.
Berkley KJ, Rapkin AJ, Papka RE. The pains of endometriosis. Science. 2005;308(5728):1587-9.
As-Sanie S, Kim J, Schmidt-Wilcke T, Sundgren PC, Clauw DJ, Napadow V, et al. Functional connectivity is associated with altered brain chemistry in women with endometriosis-associated chronic pelvic pain. The Journal of Pain. 2016;17(1):1-13.
Carey ET, Till SR, As-Sanie S. Pharmacological management of chronic pelvic pain in women. Drugs. 2017;77:285-301.
Caumo W, Deitos A, Carvalho S, Leite J, Carvalho F, Dussán-Sarria JA, et al. Motor cortex excitability and BDNF levels in chronic musculoskeletal pain according to structural pathology. Frontiers in human neuroscience. 2016;10:357.
Borghese B, Zondervan KT, Abrao MS, Chapron C, Vaiman D. Recent insights on the genetics and epigenetics of endometriosis. Clinical genetics. 2017;91(2):254-64.
Sapkota Y, Attia J, Gordon SD, Henders AK, Holliday EG, Rahmioglu N, et al. Genetic burden associated with varying degrees of disease severity in endometriosis. MHR: Basic science of reproductive medicine. 2015;21(7):594-602.
Gargett CE, Schwab KE, Brosens JJ, Puttemans P, Benagiano G, Brosens I. Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis. Molecular human reproduction. 2014;20(7):591-8.
Laganà AS, Salmeri FM, Vitale SG, Triolo O, Götte M. Stem cell trafficking during endometriosis: may epigenetics play a pivotal role? Reproductive Sciences. 2018;25(7):978-9.
Laganà AS, Garzon S, Götte M, Viganò P, Franchi M, Ghezzi F, et al. The pathogenesis of endometriosis: molecular and cell biology insights. International journal of molecular sciences. 2019;20(22):5615.
International working group of AAGL E, ESHRE, WES, Vermeulen N, Abrao MS, Einarsson JI, Horne AW, et al. Endometriosis classification, staging and reporting systems: a review on the road to a universally accepted endometriosis classification. Human Reproduction Open. 2021;2021(4):hoab025.
ACOSTA AA, VEASY C BUTTRAM J, BESCH PK, MALINAK LR, FRANKLIN RR, VANDERHEYDEN JD. A proposed classification of pelvic endometriosis. Obstetrics & Gynecology. 1973;42(1):19-25.
Lee S-Y, Koo Y-J, Lee D-H. Classification of endometriosis. Yeungnam University journal of medicine. 2021;38(1):10-8.
Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis. Human reproduction open. 2022;2022(2):hoac009.
Vercellini P, Viganò P, Buggio L, Somigliana E. “We Can Work It Out:” The Hundred Years' War between Experts of Surgical and Medical Treatment for Symptomatic Deep Endometriosis. Journal of Minimally Invasive Gynecology. 2018;25(3):356-9.
Szubert M, Ziętara M, Suzin J. Conservative treatment of deep infiltrating endometriosis: review of existing options. Gynecological Endocrinology. 2018;34(1):10-4.
Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertility and Sterility. 1996;66(5):706-11.
Ferrero S, Alessandri F, Racca A, Maggiore ULR. Treatment of pain associated with deep endometriosis: alternatives and evidence. Fertility and sterility. 2015;104(4):771-92.
Shi J, Tan X, Feng G, Zhuo Y, Jiang Z, Banda S, et al. Research advances in drug therapy of endometriosis. Frontiers in Pharmacology. 2023;14:1199010.
Capezzuoli T, Rossi M, La Torre F, Vannuccini S, Petraglia F. Hormonal drugs for the treatment of endometriosis. Current Opinion in Pharmacology. 2022;67:102311.
Koga K, Takamura M, Fujii T, Osuga Y. Prevention of the recurrence of symptom and lesions after conservative surgery for endometriosis. Fertility and sterility. 2015;104(4):793-801.
Jacobson TZ, Duffy JM, Barlow DH, Koninckx PR, Garry R. Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database of Systematic Reviews. 2009(4).
Saraswat L, Ayansina D, Cooper K, Bhattacharya S, Horne A, Bhattacharya S. Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2018;125(1):64-72.
Laganà AS, La Rosa VL. Multidisciplinary management of endometriosis: current strategies and future challenges. Minerva Medica. 2019;111(1):18-20.
Ballard K, Seaman H, De Vries CS, Wright J. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—part 1. BJOG: An International Journal of Obstetrics & Gynaecology. 2008;115(11):1382-91.
Abbott J, Hawe J, Clayton R, Garry R. The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2–5 year follow‐up. Human Reproduction. 2003;18(9):1922-7.
Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertility and sterility. 2004;82(4):878-84.
Zanelotti A, Decherney AH. Surgery and endometriosis. Clinical obstetrics and gynecology. 2017;60(3):477-84.
Wang G, Tokushige N, Markham R, Fraser IS. Rich innervation of deep infiltrating endometriosis. Human reproduction. 2009;24(4):827-34.
Kalaitzopoulos DR, Samartzis N, Kolovos GN, Mareti E, Samartzis EP, Eberhard M, et al. Treatment of endometriosis: a review with comparison of 8 guidelines. BMC women's health. 2021;21:1-9.
Berlanda N, Somigliana E, Frattaruolo MP, Buggio L, Dridi D, Vercellini P. Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017;209:67-71.
Chapron C, Querleu D, Bruhat M-A, Madelenat P, Fernandez H, Pierre F, et al. Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Human reproduction (Oxford, England). 1998;13(4):867-72.
Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertility and sterility. 2017;108(1):125-36.
Working group of ESGE E, WES, Keckstein J, Becker CM, Canis M, Feki A, et al. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Human Reproduction Open. 2020;2020(1):hoaa002.
Duffy JM, Arambage K, Correa FJ, Olive D, Farquhar C, Garry R, et al. Laparoscopic surgery for endometriosis. Cochrane Database of Systematic Reviews. 2014(4).
Byrne D, Curnow T, Smith P, Cutner A, Saridogan E, Clark TJ. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ open. 2018;8(4):e018924.
Drechsel-Grau A, Grube M, Neis F, Schoenfisch B, Kommoss S, Rall K, et al. Long-Term Follow-Up Regarding Pain Relief, Fertility, and Re-Operation after Surgery for Deep Endometriosis. Journal of Clinical Medicine. 2024;13(17):5039.
Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020;382(13):1244-56.
D’Alterio MN, D’Ancona G, Raslan M, Tinelli R, Daniilidis A, Angioni S. Management challenges of deep infiltrating endometriosis. International journal of fertility & sterility. 2021;15(2):88.
Martire FG, Giorgi M, D’Abate C, Colombi I, Ginetti A, Cannoni A, et al. Deep infiltrating endometriosis in adolescence: early diagnosis and possible Prevention of Disease Progression. Journal of Clinical Medicine. 2024;13(2):550.
Symons LK, Miller JE, Kay VR, Marks RM, Liblik K, Koti M, et al. The immunopathophysiology of endometriosis. Trends in molecular medicine. 2018;24(9):748-62.
Shigesi N, Kvaskoff M, Kirtley S, Feng Q, Fang H, Knight JC, et al. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Human reproduction update. 2019;25(4):486-503.
Tal A, Tal R, Pluchino N, Taylor HS. Endometrial cells contribute to preexisting endometriosis lesions in a mouse model of retrograde menstruation. Biology of reproduction. 2019;100(6):1453-60.
Wang Y, Nicholes K, Shih I-M. The origin and pathogenesis of endometriosis. Annual Review of Pathology: Mechanisms of Disease. 2020;15(1):71-95.
Signorile PG, Viceconte R, Baldi A. New insights in pathogenesis of endometriosis. Frontiers in medicine. 2022;9:879015.
JA S. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into peritoneal cavity. Am J Obstet Gynecol. 1927;14:422-69.
Jerman LF, Hey-Cunningham AJ. The role of the lymphatic system in endometriosis: a comprehensive review of the literature. Biology of reproduction. 2015;92(3):64, 1-10.
Nukaly HY, Dalloul R, Kayali A, Nassar J, Asiry S. Endometrioma Unveiled: A Comprehensive Review of the Pathogenesis, Diagnosis, and Current Management Strategies of Ovarian Endometriosis. Authorea Preprints. 2023.
Maruyama T. A revised stem cell theory for the pathogenesis of endometriosis. Journal of Personalized Medicine. 2022;12(2):216.
Berkley KJ, Rapkin AJ, Papka RE. The pains of endometriosis. Science. 2005;308(5728):1587-9.
As-Sanie S, Kim J, Schmidt-Wilcke T, Sundgren PC, Clauw DJ, Napadow V, et al. Functional connectivity is associated with altered brain chemistry in women with endometriosis-associated chronic pelvic pain. The Journal of Pain. 2016;17(1):1-13.
Carey ET, Till SR, As-Sanie S. Pharmacological management of chronic pelvic pain in women. Drugs. 2017;77:285-301.
Caumo W, Deitos A, Carvalho S, Leite J, Carvalho F, Dussán-Sarria JA, et al. Motor cortex excitability and BDNF levels in chronic musculoskeletal pain according to structural pathology. Frontiers in human neuroscience. 2016;10:357.
Borghese B, Zondervan KT, Abrao MS, Chapron C, Vaiman D. Recent insights on the genetics and epigenetics of endometriosis. Clinical genetics. 2017;91(2):254-64.
Sapkota Y, Attia J, Gordon SD, Henders AK, Holliday EG, Rahmioglu N, et al. Genetic burden associated with varying degrees of disease severity in endometriosis. MHR: Basic science of reproductive medicine. 2015;21(7):594-602.
Gargett CE, Schwab KE, Brosens JJ, Puttemans P, Benagiano G, Brosens I. Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis. Molecular human reproduction. 2014;20(7):591-8.
Laganà AS, Salmeri FM, Vitale SG, Triolo O, Götte M. Stem cell trafficking during endometriosis: may epigenetics play a pivotal role? Reproductive Sciences. 2018;25(7):978-9.
Laganà AS, Garzon S, Götte M, Viganò P, Franchi M, Ghezzi F, et al. The pathogenesis of endometriosis: molecular and cell biology insights. International journal of molecular sciences. 2019;20(22):5615.
International working group of AAGL E, ESHRE, WES, Vermeulen N, Abrao MS, Einarsson JI, Horne AW, et al. Endometriosis classification, staging and reporting systems: a review on the road to a universally accepted endometriosis classification. Human Reproduction Open. 2021;2021(4):hoab025.
ACOSTA AA, VEASY C BUTTRAM J, BESCH PK, MALINAK LR, FRANKLIN RR, VANDERHEYDEN JD. A proposed classification of pelvic endometriosis. Obstetrics & Gynecology. 1973;42(1):19-25.
Lee S-Y, Koo Y-J, Lee D-H. Classification of endometriosis. Yeungnam University journal of medicine. 2021;38(1):10-8.
Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis. Human reproduction open. 2022;2022(2):hoac009.
Vercellini P, Viganò P, Buggio L, Somigliana E. “We Can Work It Out:” The Hundred Years' War between Experts of Surgical and Medical Treatment for Symptomatic Deep Endometriosis. Journal of Minimally Invasive Gynecology. 2018;25(3):356-9.
Szubert M, Ziętara M, Suzin J. Conservative treatment of deep infiltrating endometriosis: review of existing options. Gynecological Endocrinology. 2018;34(1):10-4.
Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertility and Sterility. 1996;66(5):706-11.
Ferrero S, Alessandri F, Racca A, Maggiore ULR. Treatment of pain associated with deep endometriosis: alternatives and evidence. Fertility and sterility. 2015;104(4):771-92.
Shi J, Tan X, Feng G, Zhuo Y, Jiang Z, Banda S, et al. Research advances in drug therapy of endometriosis. Frontiers in Pharmacology. 2023;14:1199010.
Capezzuoli T, Rossi M, La Torre F, Vannuccini S, Petraglia F. Hormonal drugs for the treatment of endometriosis. Current Opinion in Pharmacology. 2022;67:102311.
Koga K, Takamura M, Fujii T, Osuga Y. Prevention of the recurrence of symptom and lesions after conservative surgery for endometriosis. Fertility and sterility. 2015;104(4):793-801.
Jacobson TZ, Duffy JM, Barlow DH, Koninckx PR, Garry R. Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database of Systematic Reviews. 2009(4).
Saraswat L, Ayansina D, Cooper K, Bhattacharya S, Horne A, Bhattacharya S. Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2018;125(1):64-72.
Laganà AS, La Rosa VL. Multidisciplinary management of endometriosis: current strategies and future challenges. Minerva Medica. 2019;111(1):18-20.
Ballard K, Seaman H, De Vries CS, Wright J. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—part 1. BJOG: An International Journal of Obstetrics & Gynaecology. 2008;115(11):1382-91.
Abbott J, Hawe J, Clayton R, Garry R. The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2–5 year follow‐up. Human Reproduction. 2003;18(9):1922-7.
Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertility and sterility. 2004;82(4):878-84.
Zanelotti A, Decherney AH. Surgery and endometriosis. Clinical obstetrics and gynecology. 2017;60(3):477-84.
Wang G, Tokushige N, Markham R, Fraser IS. Rich innervation of deep infiltrating endometriosis. Human reproduction. 2009;24(4):827-34.
Kalaitzopoulos DR, Samartzis N, Kolovos GN, Mareti E, Samartzis EP, Eberhard M, et al. Treatment of endometriosis: a review with comparison of 8 guidelines. BMC women's health. 2021;21:1-9.
Berlanda N, Somigliana E, Frattaruolo MP, Buggio L, Dridi D, Vercellini P. Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017;209:67-71.
Chapron C, Querleu D, Bruhat M-A, Madelenat P, Fernandez H, Pierre F, et al. Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Human reproduction (Oxford, England). 1998;13(4):867-72.
Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertility and sterility. 2017;108(1):125-36.
Working group of ESGE E, WES, Keckstein J, Becker CM, Canis M, Feki A, et al. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Human Reproduction Open. 2020;2020(1):hoaa002.
Duffy JM, Arambage K, Correa FJ, Olive D, Farquhar C, Garry R, et al. Laparoscopic surgery for endometriosis. Cochrane Database of Systematic Reviews. 2014(4).
Byrne D, Curnow T, Smith P, Cutner A, Saridogan E, Clark TJ. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ open. 2018;8(4):e018924.
Drechsel-Grau A, Grube M, Neis F, Schoenfisch B, Kommoss S, Rall K, et al. Long-Term Follow-Up Regarding Pain Relief, Fertility, and Re-Operation after Surgery for Deep Endometriosis. Journal of Clinical Medicine. 2024;13(17):5039.
Sayfalar
297-305
Gelecek
21 Ocak 2025
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