Pelvic endometriosis: Refer to the surgeon at the right moment: Pelvic endometriosis: When refer to the surgeon?
Adenomyosis
Endometrioma
Pelvic endometriosis
Surgery
Treatment
Journal
Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
26
07
2019
revised:
16
01
2020
accepted:
24
01
2020
pubmed:
7
2
2020
medline:
2
1
2021
entrez:
7
2
2020
Statut:
ppublish
Résumé
As endometriosis is not a single condition but different morphological types, it is easy to conceive that its management allow for a diversity of approaches. The objective of this literature review is about a simplified pathway through care for patients with endometriosis, and to target the right time for surgical treatment. Through a literature and references review, the different surgical care arrangements according to attainment, to symptoms and to the patients demands and expectations are reviewed. An existing literature and recommendations synthesis has been done, and it was found that an optimum medical or surgical care rely on a multidisciplinary approach. Asymptomatic patients should not have surgery, and the medical treatment precede surgical treatment in numerous indications. In case of a surgical need, the right moment is determined by the recommendations, as noted in this article. Different aspects are necessary, the symptomatology, the intend to be pregnant and the recurrence of lesions in particular, but also the use of medically assisted reproduction or not. In order to optimize the surgical treatment of patients with endometriosis, it is advisable to not refer these patients to the surgeon not too soon and not too late, furthermore if he's an expert. In all cases the treatment is multidisciplinary, and the most difficult cases are referred to multidisciplinary consultative reunion. The surgical treatment relies on "centre of expertise's" existence for some specific forms of deep endometriosis. The surgical treatment is a question of both pathology and timing. In order to optimize the surgical treatment of endometriosis, it is advisable to refer patients to the surgeon at the right moment.
Sections du résumé
BACKGROUND
BACKGROUND
As endometriosis is not a single condition but different morphological types, it is easy to conceive that its management allow for a diversity of approaches. The objective of this literature review is about a simplified pathway through care for patients with endometriosis, and to target the right time for surgical treatment.
METHODS
METHODS
Through a literature and references review, the different surgical care arrangements according to attainment, to symptoms and to the patients demands and expectations are reviewed.
RESULTS
RESULTS
An existing literature and recommendations synthesis has been done, and it was found that an optimum medical or surgical care rely on a multidisciplinary approach. Asymptomatic patients should not have surgery, and the medical treatment precede surgical treatment in numerous indications. In case of a surgical need, the right moment is determined by the recommendations, as noted in this article. Different aspects are necessary, the symptomatology, the intend to be pregnant and the recurrence of lesions in particular, but also the use of medically assisted reproduction or not.
CONCLUSION
CONCLUSIONS
In order to optimize the surgical treatment of patients with endometriosis, it is advisable to not refer these patients to the surgeon not too soon and not too late, furthermore if he's an expert. In all cases the treatment is multidisciplinary, and the most difficult cases are referred to multidisciplinary consultative reunion. The surgical treatment relies on "centre of expertise's" existence for some specific forms of deep endometriosis. The surgical treatment is a question of both pathology and timing.
BRIEF SUMMARY
METHODS
In order to optimize the surgical treatment of endometriosis, it is advisable to refer patients to the surgeon at the right moment.
Identifiants
pubmed: 32028037
pii: S2468-7847(20)30028-3
doi: 10.1016/j.jogoh.2020.101701
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101701Informations de copyright
Copyright © 2020. Published by Elsevier Masson SAS.
Déclaration de conflit d'intérêts
Declaration of Competing Interest M. Pécout and G. Doucède report no conflicts of interest. E. Jean Dit Gautier, P. Collinet and C. Rubod participated in writing recommendations on endometriosis with the CNGOF.