■放置膨体聚四氟乙烯(ePTFE,商品名Gore-Tex®)用于子宫内膜瘤≥3cm的膀胱切除术和子宫内膜异位症切除术后的粘连预防。
■在一家三级护理中心进行了一项前瞻性队列研究。56名妇女符合这项研究的资格,并接受了手术。在受影响的卵巢周围扩展的聚四氟乙烯放置是自我选择的。纳入分析标准为病理证实的子宫内膜瘤≥3cm,手术时没有子宫切除术,术后调查完成≥1年,缺乏避免怀孕的策略。ePTFE组18名妇女和对照组11名妇女符合纳入标准进行分析。ePTFE组18名妇女中的16名和对照组11名妇女中的7名受到不孕症的影响。绝对妊娠率和累积4年妊娠率,这是基于生存分析,使用生命线和调整不同的随访时间,是为所有女性以及仅为不孕症女性计算的。
■与没有聚四氟乙烯的女性相比,使用膨化聚四氟乙烯的女性的4年累积妊娠率高(85%与65%,p=0.69)。与无聚四氟乙烯的女性相比,使用膨化聚四氟乙烯的女性在手术前不孕女性的4年累积妊娠率高(83%vs.33%,p=0.89)。
■有一致的趋势,虽然没有统计学意义,与没有ePTFE的女性相比,使用ePTFE的女性的怀孕率,特别是在使用ePTFE之前有不孕史的人。这是首次研究子宫内膜异位症手术期间针对附件的粘连预防策略如何影响妊娠率。使用膨化聚四氟乙烯的妊娠率上升的趋势,特别是有不孕史的患者,很有希望,值得与更大的团体进一步研究。
UNASSIGNED: Pregnancy rates after the placement of expanded polytetrafluoroethylene (ePTFE, trade name Gore-Tex®) for adhesion prevention following cystectomy of endometriomas ≥3 cm and excision of endometriosis were analyzed in this pilot study.
UNASSIGNED: A prospective cohort study was performed at a single tertiary care center. 56 women qualified for the study and underwent surgery. Expanded polytetrafluoroethylene placement around affected ovaries was self-selected. Inclusion criteria for analysis were pathology-confirmed endometrioma ≥3 cm, no hysterectomy at time of surgery, ≥1 year of postoperative survey completion, and absence of strategies to avoid pregnancy. 18 women in the ePTFE group and 11 women in the control group met inclusion criteria for analysis. 16 of the 18 women in the ePTFE group and 7 of the 11 women in the control group were affected by infertility. Absolute pregnancy rates and cumulative 4-year pregnancy rates, which are based on survival analysis using lifetables and adjust for varying follow-up times, were calculated for all women as well as for women with infertility only.
UNASSIGNED: High cumulative 4-year pregnancy rates were observed for women with expanded polytetrafluoroethylene compared to women without (85% vs. 65%, p = 0.69). High cumulative 4-year pregnancy rates for women with infertility prior to surgery were observed for women with expanded polytetrafluoroethylene compared to women without (83% vs. 33%, p = 0.89).
UNASSIGNED: There are consistent trends, although not statistically significant, seen in pregnancy rates for women with ePTFE compared to women without, particularly in those with a history of infertility prior to ePTFE use. This is the first study examining how adhesion prevention strategy targeting the adnexa during surgery for endometriosis affects pregnancy rates. The trend towards increased pregnancy rates with expanded polytetrafluoroethylene use, particularly in patients with a history of infertility, is promising and warrants further study with larger groups.