Objective

To evaluate the perioperative outcomes of premenopausal women undergoing cystectomy or oophorectomy for ovarian endometriomas (OMAs) and other benign neoplasms.

Design

Retrospective cohort study.

Setting

Clinical database containing information from 580 US hospitals.

Patient(s)

Women 18 to 50 years old who underwent ovarian cystectomy or oophorectomy for benign indications between 2010 and 2020.

Intervention(s)

We compared procedure route, length of hospital stay, and complication rates by surgical indication (OMA vs. other benign neoplasms) and surgical procedure (cystectomy vs. oophorectomy).

Main Outcome Measure(s)

Thirty-day perioperative adverse events following adnexal surgery, including conversion to laparotomy, blood transfusion, ileus, urinary tract injury, bowel injury, readmission, and death.

Result(s)

We identified 120,208 ovarian cystectomies (28,182 OMAs and 92,026 other indications) and 53,476 oophorectomies (8,622 OMAs and 44,854 other indications). During cystectomy, patients with OMAs more commonly experienced conversion to laparotomy (5.1% vs. 3.1%) and readmission (8.5% vs. 7.1%). For oophorectomies, patients with OMAs less frequently had minimally invasive surgery (55.8% vs. 64.8%) or outpatient procedures (33.8% vs. 41.8%). Urinary tract and bowel injuries were rare. Multivariable logistic regression demonstrated that the presence of OMA predicted composite complications during cystectomy (adjusted odds ratio [aOR] 1.23, 95% confidence interval [CI] 1.18–1.28) but not during oophorectomy (aOR 1.05, 95% CI 0.99–1.12). Patients with OMAs had 1.37 times the odds of a composite complication during oophorectomy than during cystectomy (95% CI 1.28–1.47).

Conclusion(s)

Patients undergoing ovarian cystectomy for OMAs had higher rates of perioperative adverse events than patients undergoing ovarian cystectomy for other benign neoplasms. Laparotomies were performed more often during oophorectomies for OMAs than for other benign indications.

中文翻译：

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全国范围内接受卵巢子宫内膜异位症手术治疗的患者样本的围手术期结果

客观的

评估因卵巢子宫内膜异位症 (OMA) 和其他良性肿瘤接受膀胱切除术或卵巢切除术的绝经前妇女的围手术期结果。

设计

回顾性队列研究。

环境

临床数据库包含来自 580 家美国医院的信息。

耐心）

2010 年至 2020 年间因良性适应症接受卵巢囊肿切除术或卵巢切除术的 18 至 50 岁女性。

干预措施

我们通过手术适应症（OMA 与其他良性肿瘤）和手术程序（膀胱切除术与卵巢切除术）比较了手术路线、住院时间和并发症发生率。

主要观察指标）

附件手术后 30 天的围手术期不良事件，包括中转剖腹手术、输血、肠梗阻、尿路损伤、肠损伤、再入院和死亡。

结果）

我们确定了 120,208 例卵巢囊肿切除术（28,182 例 OMA 和 92,026 种其他适应症）和 53,476 例卵巢切除术（8,622 例 OMA 和 44,854 种其他适应症）。在膀胱切除术期间，OMA 患者更常经历开腹手术（5.1% 对 3.1%）和再入院（8.5% 对 7.1%）。对于卵巢切除术，OMA 患者较少接受微创手术（55.8% 对 64.8%）或门诊手术（33.8% 对 41.8%）。泌尿道和肠道损伤很少见。多变量逻辑回归表明，OMA 的存在可预测膀胱切除术期间的复合并发症（调整优势比 [aOR] 1.23，95% 置信区间 [CI] 1.18-1.28），但不预测卵巢切除术（aOR 1.05，95% CI 0.99-1.12）。患有 OMA 的患者有 1.

结论

接受 OMA 卵巢囊肿切除术的患者围手术期不良事件发生率高于接受其他良性肿瘤卵巢囊肿切除术的患者。与其他良性适应症相比，在 OMA 的卵巢切除术中进行剖腹手术的频率更高。