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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The scientific guarantor of this publication is Francois Cornelis.
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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.
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Statistics and biometry
No complex statistical methods were necessary for this paper.
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Written informed consent was waived by the Institutional Review Board.
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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