Abstract
Objective To analyse and summarise the clinical characteristics, diagnosis, treatment and prognostic features of abdominal wall endometriosis.
Methods A retrospective analysis of patients with abdominal wall endometriosis who attended Changzhou Second Hospital of Nanjing Medical University from January 2013 to December 2022 was performed. They were grouped according to the depth of infiltration of the lesion and the direction of incision, and the differences between the groups were compared.
Results A total of 228 patients with abdominal wall endometriosis were included in this study, including 210 cases with a history of abdominal transverse incision surgery, 16 cases with a history of vertical incision surgery, 1 case with a history of uterine fibroids surgery, 1 case with primary abdominal endometriosis, and 178 cases with the primary symptom of cyclic pain. They were classified as solitary and complex according to the number of lesions. Both were statistically significant for BMI, number of caesarean sections, operative time, bleeding and postoperative hospital stay (p<0.05). According to the depth of infiltration, they were divided into fascial, rectus abdominis and peritoneal types. There were differences between the three in latency time, CA125, maximum diameter of the lesion, operation time, bleeding and postoperative hospital stay (p<0.05). The direction of incision for caesarean section had no significant effect on the development of endometriosis in the abdominal wall or whether the lesions were multiple (p>0.05). On imaging, magnetic resonance imaging was more accurate for lesion typing.
Conclusion AWE should be diagnosed early and treated surgically. The clinical manifestations of the same type are different, and CA125 test and abdominal wall ultrasound can be used preoperatively to determine lesion typing. Nuclear magnetic resonance (NMR) may be used to improve preoperative preparation for difficult diagnosis or staging.