Recurrence rate of endometrioma after laparoscopic bilateral cystectomy and unilateral cystectomy and drainage in opposite side

Abstract

Introduction:Laparoscopic cystectomy of ovarian endometriosis (endometrioma) can be associated with reduction in fertility and ovarian reserve. However, unilateral cyctectomy with drainage of opposite side could lessen these negative outcomes, but it might be associated with increased recurrence rate. Therefore, this study was performed with aim to compare disease recurrence rate between these two methods of laparoscopy. Methods: This retrospective study was conducted on patients with bilateral cystectomy and unilateral cystectomy with drainage of opposite side in Arash Women’s Hospital affiliated to Tehran University of Medical Sciences in 2013-2015. Two groups were compared in recurrence rate following surgery. Relative frequency of recurrence in two groups was compared by Chi-square and multiple logistic regression (to control the effect of confounding factors). Results: In all analysis, 75 patients were available. Sonographic recurrence of the disease after 1 year was observed in 31 (41.4%) of all patients that 17 (34%) patients were in group A and 14 (56%) in group B. According to the results of Chi-square test, postoperative recurrence of the disease was not significantly different between the two groups (p=0.58), although recurrence rate in group B was higher. However, after controlling the confounding effect of age and additional drug therapy, the odds ratio for recurrence in group B compared to group A was 2.82 higher (95% CI:0.99-8.01) that was not statistically significant (p=0.051) Conclusion: Recurrence rate was lower in bilateral cystectomy compared to unilateral cystectomy with drainage of opposite side, although the difference was not significant. Studies with higher sample size are suggested to confirm the findings.

Keywords

• laparoscopy
• endometriosis
• ovarian cyst
• drainage
• recurrence