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The clinical features and long-term surgical outcomes of different types of abdominal wall endometriosis

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To classify abdominal wall endometriosis (AWE) according to the invasive levels of tissue mass, and to compare the differences in clinical characteristics between different types of AWE.

Methods

In this study, we retrospectively analyzed the clinical data of 367 patients who had undergone resection of abdominal-wall endometriotic lesions at the Peking Union Medical College Hospital from January 2008 to December 2018, and we divided the patients into three types according to their deepest level of lesion invasion. Type I designated invasion of skin and subcutaneous tissue; type II, of fascia and rectus abdominis; and type III, of peritoneum. We classified, compared, and analyzed the general conditions, clinical manifestations, auxiliary examinations, surgical conditions, postoperative conditions, and recurrence status of patients.

Results

Of the 367 patients, type I patients accounted for 13.62%, type II patients for 56.68%, and type III for 29.7%. With respect to group comparisons, we observed that as the location of the mass deepened, the rate of concurrent pelvic endometriosis increased (P = 0.007), recurrent AWE was augmented (P = 0.02), the size of the mass increased (P < 0.001), the rate of multiple lesions became elevated (P < 0.001), the rate of mesh implantation increased (P < 0.001), the length of postoperative hospital stay (P < 0.001) was lengthened, the number of postoperative fever cases (P = 0.006) increased, and the risk of drainage placement (P < 0.001) was enhanced. The 5-year cumulative recurrence rate was 3.3%, and there was no significant difference in the recurrence rate among various types of AWE.

Conclusion

Type III AWE carries more severe clinical manifestations, larger lesion size, longer operative time, greater intraoperative surgical difficulty, higher necessity of mesh implantation, and longer postoperative recovery process. Complete resection of AWE lesion is the main therapeutically approach and shows relatively low long-term recurrency rate.

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Funding

The study is funded by National Key R&D Program (Grant Number: 2017YFC1001200).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China

    Yushi Wu, Yi Dai, Junji Zhang, Xiaoyan Li, Jinghua Shi, Zhiyue Gu, Jing Zhang & Jinhua Leng

Authors
  1. Yushi Wu
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  2. Yi Dai
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  3. Junji Zhang
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  4. Xiaoyan Li
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  5. Jinghua Shi
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  6. Zhiyue Gu
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  7. Jing Zhang
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  8. Jinhua Leng
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection were completed by YW, ZG and JZ. Data analysis were performed by YW. The first draft of the manuscript was written by YW and YD, and all authors commented on previous versions of the manuscript. All authors approved publication of the final version.

Corresponding author

Correspondence to Jinhua Leng.

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Conflict of interest

The authors declare that they have no conflict of interests.

Ethics approval

This study was approved by the Ethics Committee of Peking Union Medical College Hospital (IRB No. JS-1532).

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Wu, Y., Dai, Y., Zhang, J. et al. The clinical features and long-term surgical outcomes of different types of abdominal wall endometriosis. Arch Gynecol Obstet 307, 163–168 (2023). https://doi.org/10.1007/s00404-022-06579-0

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  • DOI: https://doi.org/10.1007/s00404-022-06579-0

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