To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometriomas (AWE). Method: Sixty-four cases of AWE diagnosed at Peking Union Medical College Hospital (PUMCH) from 1983 to 2003 were reviewed retrospectively. Result: There was an AWE incidence of 0.044% among the parturients undergoing cesarean section at PUMCH, of whom 87.5% had the typical complaint of an enlarging mass and pain during menstruation. Among these women, 62 underwent low abdominal surgery for endometrioma (2 for primary umbilicus endometrioma); 2 women with small endometriomas opted for a temporary medical solution and had relief after menopause. The latent period of AWE positively correlated to the women’ s age at onset of symptoms (P < 0.001). Of the 62 women who underwent local excision, 19 had an unsatisfactory experience with medical management. There were 5 recurrences and 1 evolution to malignancy during a mean follow-up of 83.7 months. Recurrence was closely related to the size and depth of lesions. Conclusion: Because of its typical clinical manifestations, abdominal wall endometriomas could be diagnosed before pregnancy. Surgical excision is the only effective treatment and wide local excision with clear margins is the key point to prevent recurrence.
目的:研究剖宫产术后腹壁子宫内膜异位症(AWE)的临床特征,以了解其相关特点。方法:对滨州医学院附属医院在2018年1月至2024年5月期间收治的134例经组织病理证实为剖宫产术后腹壁子宫内膜异位症患者的临床资料进行回顾性分析。根据腹壁子宫内膜异位症病灶的侵袭深度及范围,将其分为皮下脂肪型、鞘膜型和腹膜型三种类型。按照内异症病灶数量分为单发型、多发型。比较腹壁子宫内膜异位症各个分型之间的临床特点及差异。结果:根据术中探查内异症病灶数分型,单发型122例(91%),多发型12例(9%)。与单发型相比,多发型AWE的手术时间长(P P P = 0.035),手术时间更长(P P P P P P Objective: To investigate the clinical characteristics of abdominal wall endometriosis (AWE) after cesarean section in order to understand its related characteristics. Methods: The clinical data of 134 patients with abdominal wall endometriosis confirmed by histopathology admitted to the Affiliated Hospital of Binzhou Medical University from January 2018 to May 2024 were retrospectively analyzed. According to the invasion depth and scope of abdominal endometriosis, the lesions were classified into subcutaneous lipomatosis, vaginalis, and peritoneum. Based on the number of endometriosis lesions, it can be divided into single types and multiple types. To compare the clinical features and differences among different types of abdominal endometriosis. Results: According to the number of intraoperative investigations, there were 122 cases (91%) of single type and 12 cases (9%) of multiple type. Compared with single-style AWE, multi-style AWE had longer operation time (P P P = 0.035), longer operation time (P P P P P P < 0.01).
