학술논문
A prospective study on laparoscopic and histopathologic diagnosis of endometriosis
Document Type
Report
Source
Journal of Evolution of Medical and Dental Sciences. August 4, 2016, Vol. 5 Issue 62, p4369, 5 p.
Subject
Language
English
ISSN
2278-4748
Abstract
INTRODUCTION Endometriosis is the third leading cause of gynaecological admissions. It is a progressive disease which is both physically and mentally debilitating and the usual time interval between the onset [...]
BACKGROUND Endometriosis is a common benign gynaecological disorder. The true prevalence is difficult to quantify as women with disease are often asymptomatic and imaging modalities have low sensitivities for diagnosis. The primary method of diagnosis is Laparo scopy with or without biopsy for histologic diagnosis. Strict histologic criteria will confirm the surgical diagnosis in ap proximately 50-65% of cases. DESIGN, SETTING AND METHODS This is a prospective observational institution based study. A total of 50 patients undergoing laparoscopy were included in the study in accordance with the inclusion and exclusion criteria. The results were tabulated for comparison and standard statistical software were used for data presentation. RESULTS In this study, we observed that laparoscopy although adequately sensitive to diagnose endometriosis lacks the specificity except in the case of ovarian endometriosis. So laparoscopy without histological confirmation may give rise to false positive results, which may lead to overtreatment of patients. Due to the high negative predictive value of laparoscopy, absence of lesion anywhere on laparoscopy can virtually exclude the diagnosis of endometriosis, saving both time and expertise. CONCLUSION We conclude that laparoscopy should always be combined with histopathology for accurate diagnosis in presence of any suggestive or doubtful lesion, but is not mandatory in absence of lesion anywhere in the pelvis. The laparoscopic staging of endometriosis has a positive correlation with histologic diagnosis of endometriosis. KEYWORDS Endometriosis, Laparoscopy, Ovarian, Gynaecology.
BACKGROUND Endometriosis is a common benign gynaecological disorder. The true prevalence is difficult to quantify as women with disease are often asymptomatic and imaging modalities have low sensitivities for diagnosis. The primary method of diagnosis is Laparo scopy with or without biopsy for histologic diagnosis. Strict histologic criteria will confirm the surgical diagnosis in ap proximately 50-65% of cases. DESIGN, SETTING AND METHODS This is a prospective observational institution based study. A total of 50 patients undergoing laparoscopy were included in the study in accordance with the inclusion and exclusion criteria. The results were tabulated for comparison and standard statistical software were used for data presentation. RESULTS In this study, we observed that laparoscopy although adequately sensitive to diagnose endometriosis lacks the specificity except in the case of ovarian endometriosis. So laparoscopy without histological confirmation may give rise to false positive results, which may lead to overtreatment of patients. Due to the high negative predictive value of laparoscopy, absence of lesion anywhere on laparoscopy can virtually exclude the diagnosis of endometriosis, saving both time and expertise. CONCLUSION We conclude that laparoscopy should always be combined with histopathology for accurate diagnosis in presence of any suggestive or doubtful lesion, but is not mandatory in absence of lesion anywhere in the pelvis. The laparoscopic staging of endometriosis has a positive correlation with histologic diagnosis of endometriosis. KEYWORDS Endometriosis, Laparoscopy, Ovarian, Gynaecology.