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Abstract：
OBJECTIVE: To provide technical guidance on applying catheter-directed and needle-directed ethanol sclerotherapy for endometriomas and present the results of these sclerotherapy methods.
METHODS: From January 2015 to March 2021, the results of the patients with symptomatic ovarian endometriomas who underwent needle-directed or catheter-directed sclerotherapy were evaluated, retrospectively. The decision to apply which sclerotherapy technique was made during the procedure for each patient considering the following factors: cyst size, cyst location, cyst viscosity, and tissue rigidity.
RESULTS: Both needle-directed (n = 34 cysts) and catheter-directed (n = 34 cysts) sclerotherapy techniques were effective, with a 100% technical success rate and a 97% clinical success rate. In two of 34 cysts (6%) treated with needle-directed sclerotherapy, recurrence was detected and successfully retreated with catheter-directed sclerotherapy. Significant reductions in cyst size, pain, and serum cancer antigen 125 levels (p < 0.05) were noted. Serum anti-Müllerian hormone levels remained unaffected, indicating preserved ovarian reserve (p > 0.05). Among those treated for infertility, the pregnancy rate was 54% (n = 6/11). The mean ± SD cyst size decline was greater in catheter-directed sclerotherapy than needle-directed sclerotherapy (5.5 ± 3.1 cm vs. 4.0 ± 2.1 cm, p < 0.05). However, the pretreatment cyst volumes were considerably higher in catheter-directed sclerotherapy group (202.0 ± 233.5 mL vs. 78.8 ± 59.7 mL, p < 0.05) and were associated with significant post-treatment volume decrease (p < 0.05).
CONCLUSIONS: The choice between catheter-directed and needle-directed ethanol sclerotherapy should be determined during the procedure, with a preference for catheter-directed sclerotherapy when feasible. Crucial factors in making this decision include cyst size, cyst location, cyst viscosity, and tissue rigidity. Level of evidence Level 3, non-controlled retrospective cohort study.
METHODS: From January 2015 to March 2021, the results of the patients with symptomatic ovarian endometriomas who underwent needle-directed or catheter-directed sclerotherapy were evaluated, retrospectively. The decision to apply which sclerotherapy technique was made during the procedure for each patient considering the following factors: cyst size, cyst location, cyst viscosity, and tissue rigidity.
RESULTS: Both needle-directed (n = 34 cysts) and catheter-directed (n = 34 cysts) sclerotherapy techniques were effective, with a 100% technical success rate and a 97% clinical success rate. In two of 34 cysts (6%) treated with needle-directed sclerotherapy, recurrence was detected and successfully retreated with catheter-directed sclerotherapy. Significant reductions in cyst size, pain, and serum cancer antigen 125 levels (p < 0.05) were noted. Serum anti-Müllerian hormone levels remained unaffected, indicating preserved ovarian reserve (p > 0.05). Among those treated for infertility, the pregnancy rate was 54% (n = 6/11). The mean ± SD cyst size decline was greater in catheter-directed sclerotherapy than needle-directed sclerotherapy (5.5 ± 3.1 cm vs. 4.0 ± 2.1 cm, p < 0.05). However, the pretreatment cyst volumes were considerably higher in catheter-directed sclerotherapy group (202.0 ± 233.5 mL vs. 78.8 ± 59.7 mL, p < 0.05) and were associated with significant post-treatment volume decrease (p < 0.05).
CONCLUSIONS: The choice between catheter-directed and needle-directed ethanol sclerotherapy should be determined during the procedure, with a preference for catheter-directed sclerotherapy when feasible. Crucial factors in making this decision include cyst size, cyst location, cyst viscosity, and tissue rigidity. Level of evidence Level 3, non-controlled retrospective cohort study.
摘要：
目的：为子宫内膜瘤的导管导向和针导向乙醇硬化治疗提供技术指导，并介绍这些硬化治疗方法的结果。
方法：从2015年1月至2021年3月，评估了接受针针或导管硬化治疗的有症状的卵巢子宫内膜瘤患者的结果，回顾性。考虑以下因素，在手术过程中对每位患者应用哪种硬化治疗技术的决定：囊肿大小，囊肿位置,囊肿粘度,和组织刚性。
结果：针式（n=34个囊肿）和导管式（n=34个囊肿）硬化治疗技术均有效，100%的技术成功率和97%的临床成功率。在接受针头定向硬化治疗的34个囊肿中，有两个（6％），发现复发,并通过导管定向硬化治疗成功复治.囊肿大小显著缩小，疼痛,和血清癌抗原125水平（p<0.05）。血清抗苗勒管激素水平未受影响，表明卵巢储备保留（p>0.05）。在那些治疗不孕症的人中，妊娠率为54%(n=6/11)。导管定向硬化疗法的平均±SD囊肿大小下降大于针针定向硬化疗法（5.5±3.1cmvs.4.0±2.1cm,p<0.05)。然而,导管定向硬化治疗组的治疗前囊肿体积明显更高（202.0±233.5mLvs.78.8±59.7mL,p<0.05），并与治疗后体积的显着减少有关（p<0.05）。
结论：应在手术过程中确定导管定向和针头定向乙醇硬化疗法之间的选择，在可行的情况下，首选导管定向硬化治疗。做出这个决定的关键因素包括囊肿大小，囊肿位置,囊肿粘度,和组织刚性。证据水平3级，非对照回顾性队列研究。
方法：从2015年1月至2021年3月，评估了接受针针或导管硬化治疗的有症状的卵巢子宫内膜瘤患者的结果，回顾性。考虑以下因素，在手术过程中对每位患者应用哪种硬化治疗技术的决定：囊肿大小，囊肿位置,囊肿粘度,和组织刚性。
结果：针式（n=34个囊肿）和导管式（n=34个囊肿）硬化治疗技术均有效，100%的技术成功率和97%的临床成功率。在接受针头定向硬化治疗的34个囊肿中，有两个（6％），发现复发,并通过导管定向硬化治疗成功复治.囊肿大小显著缩小，疼痛,和血清癌抗原125水平（p<0.05）。血清抗苗勒管激素水平未受影响，表明卵巢储备保留（p>0.05）。在那些治疗不孕症的人中，妊娠率为54%(n=6/11)。导管定向硬化疗法的平均±SD囊肿大小下降大于针针定向硬化疗法（5.5±3.1cmvs.4.0±2.1cm,p<0.05)。然而,导管定向硬化治疗组的治疗前囊肿体积明显更高（202.0±233.5mLvs.78.8±59.7mL,p<0.05），并与治疗后体积的显着减少有关（p<0.05）。
结论：应在手术过程中确定导管定向和针头定向乙醇硬化疗法之间的选择，在可行的情况下，首选导管定向硬化治疗。做出这个决定的关键因素包括囊肿大小，囊肿位置,囊肿粘度,和组织刚性。证据水平3级，非对照回顾性队列研究。
