The Journal of the American Association of Gynecologic Laparoscopists, 10(1), 85-89
Abstract
Objective To evaluate the reliability of diagnosing minimal and mild endometriosis under routine conditions, and to determine to what extent disease activity is taken into account.
Design Retrospective analysis (Canadian Task Force classification II-2).
Setting University teaching hospital.
Intervention Laparoscopy.
Patients One hundred eighteen consecutive women with minimal and mild endometriosis undergoing routine surgery between 1994 and 1999.
MEASUREMENTS AND
Main Results Analytic parameters were the total number of endometriotic lesions; intraoperative description of pigmented, nonpigmented, and nondefined lesions; and number of extirpated lesions and histologic detection rate. In 118 patients, 311 suspected endometriotic lesions were documented. Nonpigmented lesions were reported in only 27% of women. In 51% of surgical reports no importance was attached to disease morphology or activity. Only 1.2 biopsies/patient were taken. The histologic detection rate was 56%. In 49 patients the assumed intraoperative diagnosis was confirmed by histologic examination.
Conclusions Intraoperative description of endometriotic lesions is inadequate. Little attention is paid to the activity of the illness. There is room for improvement in the number of excisions and histologic detection, and an attempt should be made to find a way out of this diagnostic dilemma.
minimal mild endometriosis diagnostic accuracy laparoscopy, endometriosis lesion intraoperative description reliability, pigmented nonpigmented endometriosis lesion identification, histologic detection rate endometriosis biopsy, endometriosis staging revised AFS classification laparoscopy, endometriosis disease activity morphology assessment, Buchweitz endometriosis diagnostic dilemma routine surgery, endometriosis excision biopsy histologic confirmation rate, subtle endometriosis lesion recognition laparoscopic surgery, retrospective analysis endometriosis diagnosis improvement
PMID 12555000 12555000 DOI 10.1016/s1074-3804(05)60240-x 10.1016/s1074-3804(05)60240-x
Keywords
Adult, Aged, Biopsy, Needle, Endometriosis/diagnosis/pathology/surgery, Female, Follow-Up Studies, Gynecologic Surgical Procedures/methods, Humans, Middle Aged, Retrospective Studies, Risk Assessment, Severity of Illness Index, Treatment Outcome