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Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the outcomes of percutaneous image-guided cryoablation of symptomatic abdominal wall endometriosis (AWE) versus surgery alone.

Methods

From 2004 to 2016, cryoablation or surgery alone was performed under local (n = 5) or general anaesthesia (n = 15) for AWE in a single institution in 7 (mean age, 36.1 years) and 13 (mean age, 31.9 years) patients, respectively. Fifteen lesions were treated by cryoablation (mean size, 2.3 cm; range, 0.5-7 cm) and 16 by surgery (2.5 cm; 1.1-3.4 cm). Tolerance, efficacy and patient and procedural characteristics were compared.

Results

Median follow-up was 22.5 (range, 6-42) months after cryoablation and 54 (14-149) after surgery. The median procedure and hospitalisation durations were 41.5 min (24-66) and 0.8 days (0-1) after cryoablation, and 73.5 min (35-160) and 2.8 days (1-12 days) after surgery (both P = 0.01). Three patients (23.1%) had severe complications and nine aesthetic sequels (69.2%) after surgery, none after cryoablation (P = 0.05). The median 12- and 24-month symptom free-survival rates were 100% and 66.7% (95% CI, 5.4; 94.5) after cryoablation and 92% (55.3; 98.9) after surgery at both time points (P = 0.45).

Conclusions

Cryoablation presents similar effectiveness to surgery alone for local control of AWE while reducing hospitalisation duration and complications. Any aesthetic sequels were associated with the cryoablation treatment.

Key points

• Hospitalisation is shorter after cryoablation than after surgery of abdominal wall endometriosis.

• A significantly lower rate of complications is observed after cryoablation compared to surgery.

• Cryoablation of abdominal wall endometriosis presents similar effectiveness to surgery alone.

• A significant reduction of pain is observed 6 months after treatment.

• A significant reduction of abdominal wall endometriosis is observed at 6 months.

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau for medical editorial services.

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Authors and Affiliations

  1. Service d’imagerie diagnostique et thérapeutique de l’adulte, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France

    Julie Maillot, Nicolas Grenier & François H. Cornelis

  2. Service de gynecologie, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France

    Jean Luc Brun

  3. Service de chirurgie, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France

    Vincent Dubuisson

  4. Service de radiologie, Hôpital Tenon, APHP, 4 rue de la Chine, 75020, Paris, France

    Marc Bazot & François H. Cornelis

Authors
  1. Julie Maillot
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  2. Jean Luc Brun
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  3. Vincent Dubuisson
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  4. Marc Bazot
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  5. Nicolas Grenier
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  6. François H. Cornelis
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Corresponding author

Correspondence to François H. Cornelis.

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Guarantor

The scientific guarantor of this publication is Francois Cornelis.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts (n = 4) have been previously reported in Cornelis et al. [16].

Methodology

• Retrospective

• Case-control study

• Performed at one institution

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Maillot, J., Brun, J.L., Dubuisson, V. et al. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol 27, 4298–4306 (2017). https://doi.org/10.1007/s00330-017-4827-7

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  • DOI: https://doi.org/10.1007/s00330-017-4827-7

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