Relevance Factor Analysis Of Ovarian Endometriosis Recurrence After Operation Treatment

Objective: Ovarian endometriosis is a common and frequently-occuringdisease in gynaecology, recently, there is a noticeable increase inits incidence. The common symptoms of OM are dysmenorrhea,dyspareunia and infertility. The aim of therapyis in Clinical is to relduce thesymptoms and promote fertility. There is a high postoperative recurrencein conservative surgery in OM patients, and the related factors influencingthe postoperative recurrence have paid more attention by experts all overthe world. Through the retrospective analysis to explore the related factorsof recurrence in this research, and find methods to prevent the recurrenceof OM.Methods: To select377cases of OM patients with conservative surgeryin the gynecology in second hospital of Jilin University from December,2010to December2012, the recurrence of cases regard as observationgroup that in follow-up, and the other did not recurrence cases regard ascontrol group, those377OM patients were analyzed retrospectively.According to compare recurrence rate, the regression cofficients andother factors to find out the related factors.Result:1. Two years later, the OM recurrence rate was13.73%(49/357)who accepted conservative surgery.2. The recurrence rate was different in different ages,0%（0/3）in under18years of age group,15.33%（49/322）in18to45years old group,0%（0/32）in over45years of age group. abortion and times may be relate torecurrence rate of OM,13.74%（29/211）in none abortion,8.25%（8/97）in once abortion,8.25%（8/97）in twice abortion,45%（9/20）in third andover third abortion. Taking different approach in surgery result in different recurrence of OM,17.78%（40/225）in open surgery group,6.82%（9/132）in laparoscope approach group. Postoperation the recurrence of OM was6.31%（7/111）in the patients who conducted drug therapy,and it was17.07%（42/246）in the patients who dose not conducted drug therapy.Postoperation the recurrence of OM was3.26%(3/92) and17.36%（46/225）in past pregnancies group and none pregnanciesgroup,respectively, the recurrence rate was9.2%（16/174）and18.00%（33/183） in unilateral and bilateral respectively when the first surgery,The recurrence rate was different in different size of mass group,5.5%（3/54）in the group that the diameter less than5cm,12.7%（26/204）inthe group that the diameter between5cm and10cm,20.2%（20/99）in thegroup that the diameter over10cm. The recurrence of OM was15.88%（44/277）and6.25%（5/80）with dysmenorrhea or not, respectively, Therecurrence of OM was22.34%（21/94）and10.65%（28/263）in the groupthat with adenomyosis or not, respectively. According to comparevariables in above groups may be statistically significant(P<0.05).3. The Logistic regression analysis result with single factor show thatthese numbers6.049、4.866、19.258、7.488、5.883、8.439、11.462、6.865、7.997（P＜0.05） were the wald of first onset age, dysmenorrheaor not,Abortion and times, postoperative drug therapy or not, single ordouble side was operationed in the first time, operation approach,postoperative pregnancy or not, the size of mass, with adenomyosis ornot.4. The Logistic regression analysis result with multi-factor show that allOR value is greater than1that include first onset age, dysmenorrhea ornot,Abortion and times, single or double side was operationed in the firsttime, the size of mass, with adenomyosis or not, and those regressioncoefficients β＞0, among them, abortion, dysmenorrhea and the size ofmass OR＞3, the first onset age and with adenomyosis or not OR＞1.5.pregnancies after surgery, postoperative drug therapy and laparoscopicsurgery OR＜1, and regression coefficientsβ＜0. Conclusion:1, The independent factors that influence OM recurrence include the firstonset age, dysmenorrhea or not, abortion and times, postoperativedrug therapy or not, single or double side was operationed in the first time,operation approach, postoperative pregnancy or not, the size of mass,with adenomyosis or not.2, There are six factors may be relate to the recurrence of OM, includingthe first onset age, dysmenorrhea or not, abortion and times, single ordouble side was operationed in the first time, the size of mass, withadenomyosis or not, and the abortion, dysmenorrhea, a big size of massin the first surgery may be the high risk factors, the first onset age, withadenomyosis may be the middle risk factors.3, Abortion, drug therapy after surgery and using laparoscopy in surgerymay be reduce the recurrence of OM.4, Reproductive age women have a hige OM recurrence rate, we couldutlize laparoscopy in the surgery to reduce the recurrence of OM,under the drug therapy guided by experts after the surgeryor postoperative pregnancy, measures such as assisted reproductiontechnology may be taken if necessary.