Clinical Research Of Laparoscopic Focus Excision Combined With GnRH-a In The Treatment Of Deep Infiltrating Endometriosis

Objectives: To investigate the clinical efficacy of laparoscopic focus excision combined with gonadotropin-releasing hormone agonist(GnRH-a)in the treatment of deep infiltrating endometriosis(DIE).The relationship between preoperative pelvic pain in patients with DIE and r-AFS stage(the scoring system for laparoscopic diagnosis of endogeneity revised by the American Fertility Society)and the content of nerve fibers in the lesion was analyzed.Materials and Methods: A retrospective analysis was performed on the clinical data of DIE patients who underwent laparoscopic lesion resection combined with GnRH-a treatment in our hospital from January 2017 to December 2019.The relationship between preoperative pelvic pain and r-AFS stage was analyzed based on visual analog scale(VAS)and r-AFS stage,and the improvement of pelvic pain after laparoscopic focal resection combined with GnRH-a treatment was evaluated.And recurrence of endometriosis and pelvic pain within 1 year after surgery.HE staining was used to detect the content of nerve fibers in DIE lesions and analyze the relationship between the content of nerve fibers in the lesions and the degree of pelvic pain before surgery.Results: A total of 56 patients were enrolled in this study,and the results shows that there was no significant correlation between r-AFS stage and the degree of preoperative pelvic pain in patients with DIE(r = 0.215,P > 0.05).The VAS scores of1 month,6 months and 12 months after surgery were 1.27±0.90,2.55±1.24 and3.73±1.71,respectively,which were significantly lower than preoperative VAS score(4.91±2.35),and the differences were statistically significant(P < 0.001).One year after operation,there were 3 cases of recurrence,including 2 cases of symptom recurrence and 1 case of mass recurrence,with a total recurrence rate of 5%.In 56 patients with DIE,the content of nerve fibers in postoperative lesions was positively correlated with the degree of preoperative pelvic pain(r = 0.354,P < 0.05).Conclusion: Laparoscopic focal excision combined with GnRH-a in the treatment of DIE can effectively relieve the pain symptoms of DIE patients.The content of nerve fibers in DIE lesions was positively correlated with the degree of pelvic pain.