Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study.
Por:
Garcia-Tejedor A, Martinez-Garcia JM, Candas B, Suarez E, Mañalich L, Gomez M, Merino E, Castellarnau M, Regueiro P, Carreras M, Martínez E, Carrarach M, Subirats N, Barbera J, Gonzalez S, Climent M, Fernández-Montolí E and Ponce J
Publicada:
1 jul 2020
Ahead of Print:
7 abr 2020
Categoría:
Obstetrics and gynecology
Resumen:
STUDY OBJECTIVE: To compare the cost-effectiveness of ultrasound (US)-guided aspiration and ethanol sclerotherapy versus laparoscopic surgery for benign-appearing ovarian endometrioma. DESIGN: Prospective, cohort pilot study. SETTING: Multiple centers, Spain. PATIENTS: Forty patients with suspected ovarian endometrioma identified by US, with a maximum diameter of 35 to 100 mm, of whom 33 met inclusion criteria. INTERVENTIONS: The study group (n?=?17) underwent US-guided aspiration plus sclerotherapy with ethanol, and the control group (n?=?14) underwent laparoscopic cystectomy. MEASUREMENTS AND MAIN RESULTS: Recurrence, complications, and direct costs were compared. One of 17 sclerotherapy patients recurred (5.9%) compared with 4 of 14 laparoscopic surgery patients (28.6%) (odds ratio 0.18, 0.01-1.53). No serious adverse effects (Clavien-Dindo = III) were observed in the sclerotherapy group; 1 patient in the surgery group had a Clavien-Dindo IIIb complication. Median hospital direct costs were significantly lower in the sclerotherapy group than those in the surgery group-266 euros versus 2189 euros. CONCLUSION: Ethanol sclerotherapy seems to be cost-effective for endometrioma and also appears to reduce complications. In this pilot study, recurrence was not higher than with conventional surgery.
Filiaciones:
Garcia-Tejedor A:
Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
Martinez-Garcia JM:
Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
Candas B:
Department of Biochemistry and Molecular Biology, Clinical Laboratory, Hospital Universitari Bellvitge, Hospitalet de Llobregat, IDIBELL, Barcelona, Spain
Suarez E:
Department of Gynaecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Mañalich L:
Department of Gynaecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Gomez M:
Department of Gynaecology, Hospital Universitari Joan XXIII, Tarragona, Spain
Merino E:
Department of Gynaecology Hospital Universitari Doctor Josep Trueta, Girona, Spain
Castellarnau M:
Department of Gynaecology, Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, Spain
Regueiro P:
Department of Gynaecology, Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, Spain
Carreras M:
Department of Gynaecology, Hospital de Sant Joan de Déu de Sant Boi, Sant Boi de Llobregat, Barcelona, Spain
Martínez E:
Department of Gynaecology, Hospital de Sant Joan de Déu de Sant Boi, Sant Boi de Llobregat, Barcelona, Spain
Carrarach M:
Department of Gynaecology, Hospital de Viladecans, Viladecans, Barcelona, Spain
Subirats N:
Department of Gynaecology, Hospital Verge de La Cinta, Tortosa, Tarragona, Spain
Barbera J:
Department of Gynaecology, Hospital Verge de La Cinta, Tortosa, Tarragona, Spain
Gonzalez S:
Department of Gynaecology, Hospital de Sant Joan de Déu d'Esplugues, Esplugues de Llobregat, Barcelona, Spain
Climent M:
Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
Fernández-Montolí E:
Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
Ponce J:
Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
Bronze
|