Diskrepance stagingové a peroperační klasifikace endometriózy pánve dle #Enzian 2021



Year of publication 2024
Type Article in Periodical
MU Faculty or unit

Faculty of Medicine

Doi http://dx.doi.org/10.48095/cccg20241
Keywords staging classification; #Enzian 2021; discrepancy; endometrioma; ovarian form of endometriosis
Description Summary: Aim: The aim of this study is to compare the extent of ovarian endometriosis diagnosed at preoperative staging with subsequent perioperative findings. Definition of discrepancies observed according to the #Enzian 2021 classification. Material and methods: The cohort includes 62 patients of reproductive age with preoperative findings of ovarian endometrioma. Patients were divided according to the #Enzian 2021 classification into subgroups (O1, O2 + O3) with unilateral and bilateral findings. The percentage concordance of preoperative and perioperative findings was evaluated. Results: In the evaluation of ovarian involvement, the preoperative ultrasound diagnosis shows almost 100% agreement with the findings on the ovaries during surgery. Periadnexal adhesions were predicted preoperatively in only half of the cases. The difference in laterality was confirmed with T3 involvement in the O2 + O3 subgroup. In the bilateral involvement, the finding of the presence of grade 3 adhesions was doubled. An association of ovarian form of endometriosis (O2–O3) with deep infiltrating endometriosis of the small pelvis was observed in 50% of the cohort. Conclusion: The ovarian form of endometriosis is associated with the occurrence of other endometriosis lesions in the small pelvis. In this study, it was confirmed that preoperative staging underestimates the extent of endometriosis in the small pelvis. In the surgical management of ovarian endometriosis, extensive adhesive process should be expected.

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