Clinical Analysis Of79Cases Of Abdominal Wall Endometriosis

Background and Objective：Endometriosis (endometriosis, EMT)is short for endometriosis. It refers that endometrial tissue (glands andstroma) with functions of growth appears in the other parts outside theuterine cavity coating membrane and its muscle layer. The disease iscalled “benign carcinoma” although it belongs to benign disease, becauseof the performance of the malignant biological behavior proliferation,invasion and metastasis. The disease usually occurs in pelvic cavity, withthe most common ovarian, relatively rarely in extrapelvic. Abdominalwall endometriosis (abdominalwall endome-triosis, AWE) is the mostcommon type of extra pelvic endometriosis, majority of the cases with ahistory of abdominal surgery, and the most of them were found incesarean section scar. It shows that the incidence of AWE after cesareansection is between0.03%-0.47%according to domestic research. Inrecent years, the cesarean section rate in our country has been so high thatabdominal wall endometriosis is tending to increase. Not only does thedisease have brought in patients physical and mental pain, it alsoincreases financial burden to them. In this study,a retrospective analysisof the clinical materials of79cases of abdominal wall endometriosispatients hospitalized in the First Hospital of Jilin University duringFebrery2009to July2013, to explore the relative factors influencing abdominal wall endometriosis, wishing to provide the reference how toreduce the incidence and postoperative recurrence rate of abdominal wallendometriosis in the future.Method：Retrospectively analysis the clinal materials of the79caseof AWE sufferers who had surgical removal of the lesion and had beenconfirmed with postoperative pathological diagonosis and telephone themfollow-up.The results are all analyzed by SPSS17.0software.Results：1. Linear regression analysis suggests the incubation period and theonset age are positively correlated (r=0.326, P=0.326), the differenceis statistically significant; the incubation period and the age of cesarean,menstrual cycle are negatively correlated, but the differences are notstatistically significant.2. The IP of the AWE patients’ age>30years old (39cases) is longerthan the ones age≤30years old(40cases), whose difference is statisticallysignificant (t=-2.217,P=0.03). In addition, the IP of the patients menstrualcycle≥28days (62cases) is longer than the patients cycle＜28days(17cases), whose difference is statistically significant (t=-2.639，P=0.01).The difference of the patients’ cesarean delivery between age>30yearsold (9cases)and age≤30years old (70cases) influencing the IP, is nottatistically significant (t=1.206，P=0.208).3. All the79patients were confirmed as abdominal wall endometriosis before the surgery, and they all were treated in surgicaltherapy. During the operation cut the edge from the lesions edge0.5-1.0cm outside.There are19patients with postoperative medication.4. There were only63cases follow-up of all79cases, and13patients of them got the pain near their abdominal scar again among thefollow-ups which contained2patients who has a mass around theincision associating with the menstrual cycle.The13ones were allconfirmed as AWE Recurrence. Among the13recurrent patients, thereare3patients with the size of tumor>3cm,9patients with transversecesarean section and9cases without postoperative medical adjuvanttreatments.Conclusion1. It is the key point to control the indications of cesacean sectionstrictly and reduce the cesarean section rate for decreasing the AWEincidence rate.2. The onset age and the menstrual cycle of the AWE patients arerelated with the incubation period,however, the cesarean delivery age andthe history of primary dysmenorrhea have no significant correlation.3. The incidence and the recurrence rate of the cases with transversecesarean section are both higher than the vertical ones, which support theplanting theory of ectopic endometrium, so there is another importantfactor to choose the correct incision and protect it during the cesarean section for decreasing the AWE incidence and recurrence rate.