Transvaginal sonography determines accurately extent of infiltration of rectosigmoid deep endometriosis.


Journal

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340

Informations de publication

Date de publication:
Dec 2021
Historique:
revised: 16 06 2021
received: 03 03 2021
accepted: 16 06 2021
pubmed: 29 6 2021
medline: 28 12 2021
entrez: 28 6 2021
Statut: ppublish

Résumé

To investigate the agreement of measurements of the three diameters of rectosigmoid deep endometriosis (DE) lesions between presurgical evaluation using transvaginal sonography (TVS) and postsurgical specimen measurement (PSM). This was a prospective observational multicenter study including symptomatic women undergoing surgical treatment for DE involving the rectosigmoid, by either discoid or segmental resection, from April 2017 to December 2019. TVS was performed presurgically to evaluate lesion size (craniocaudal-midsagittal length, anteroposterior thickness and transverse diameter), in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement, and was compared with PSM. The agreement of lesion dimensions between the two methods was assessed by Bland-Altman plots and limits of agreement and additionally by the intraclass correlation coefficient (ICC) and Pearson's correlation coefficient. Systematic and proportional bias was assessed using the paired t-test. A total of 207 consecutive women were eligible for inclusion. Forty-one women were excluded, leaving 166 women for final analysis. A total of 123 segmental resections and 46 discoid resections were performed (both procedures were performed in three women). The mean difference between TVS and PSM was 0.90 (95% CI, 0.85-0.95) mm for lesion length measurements, 1.03 (95% CI, 0.98-1.09) mm for lesion thickness measurements and 0.84 (95% CI, 0.79-0.89) mm for transverse diameter measurements. Bland-Altman analysis demonstrated good agreement between the two methods for measurements of lesion length. Furthermore, there was good reliability and correlation between TVS and PSM for lesion length measurements, as demonstrated by an ICC of 0.82 (95% CI, 0.75-0.87) and Pearson's correlation coefficient of 0.72 (95% CI, 0.62-0.80), moderate-to-good reliability and correlation for lesion thickness measurements, with an ICC of 0.76 (95% CI, 0.67-0.82) and Pearson's correlation coefficient of 0.61 (95% CI, 0.51-0.70), and poor-to-moderate reliability and correlation for transverse diameter measurements, with an ICC of 0.58 (95% CI, 0.39-0.71) and Pearson's correlation coefficient of 0.46 (95% CI, 0.33-0.58). Preoperative TVS determines accurately rectosigmoid DE lesion length. TVS can thereby contribute to optimal planning of surgical treatment options in women with rectosigmoid DE. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Identifiants

pubmed: 34182605
doi: 10.1002/uog.23728
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

933-939

Informations de copyright

© 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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Auteurs

M K Aas-Eng (MK)

Department of Gynecology, Oslo University Hospital, Oslo, Norway.
Department of Gynecology, Certified Center for Endometriosis and Pelvic Pain, Hospital St John of God, Vienna, Austria.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

M Lieng (M)

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.

B Dauser (B)

Department of Surgery, Hospital St John of God, Vienna, Austria.

L M Diep (LM)

Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.

M Leonardi (M)

Acute Gynecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School, Nepean Hospital, Sydney, Australia.
Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.

G Condous (G)

Acute Gynecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School, Nepean Hospital, Sydney, Australia.

G Hudelist (G)

Department of Gynecology, Certified Center for Endometriosis and Pelvic Pain, Hospital St John of God, Vienna, Austria.
Scientific Endometriosis Foundation (SEF, Stiftung Endometriose Forschung), Westerstede, Germany.

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