Abstract
Study Objective
To evaluate the cumulative recurrence rate of endometriomas after a laparoscopic endometriotic
cyst enucleation in adolescents and to find the factors associated with recurrence.
Design
A multicenter retrospective cohort study.
Setting
Three university hospitals.
Participants
One hundred five patients surgically treated with laparoscopic enucleation of endometriotic
cysts younger than 20 years of age were selected.
Interventions
None.
Main Outcome Measures
Endometrioma recurrence was considered when transvaginal or transrectal sonography
indicated a cystic mass with a diameter of 20 mm or greater. Recurrence rate of endometrioma
and median time to recurrence were evaluated.
Results
In total, 105 patients were followed for 47.3 (±44.3) months (range, 3-161 months).
Seventeen patients (16.2%) experienced recurrence after the first-line surgery and
8 patients (7%) underwent a second surgery. The median time to recurrence was 53.0
(±8.5) months (range, 8-111 months). Using Kaplan-Meier method, the cumulative recurrence
rates of endometrioma per patient at 24, 36, 60, and 96 months after the first-line
surgery were 6.4%, 10%, 19.9% and 30.9%, respectively. Surgical characteristics, such
as the diameter of the cyst, revised American Society for Reproductive Medicine stage,
unilateral or bilateral involvement, and coexistence of deep endometriosis were not
associated with recurrence in this age group.
Conclusion
Although the short-term recurrence rate in adolescents after first-line surgery is
relatively low, the recurrence rate appears to be higher according to the follow-up
duration. Long-term and continuous follow-up is needed for patients who have undergone
surgical treatment for endometriosis in the adolescent period.
Key Words
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Article info
Publication history
Published online: November 20, 2015
Footnotes
The authors indicate no conflicts of interest.
Soo Yoon Lee and Mi-La Kim should be regarded as joint first authors.
Identification
Copyright
© 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
