Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth

Background: To evaluate the clinical efficacy and safety of the modified laparoscopic inverted triangle model for extended lesion resection in treating dysmenorrhea focal adenomyosis in women who have completed childbirth. Methods: A total of 52 patients with dysmenorrhea focal adenomyosis treated i...

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Main Authors: Libing Liu, Weiwei Wei, Huimin Tang, Yao Chen, Hong Zheng, Bin Tang, Ruxia Shi, Jiming Chen, Bairong Xia, Bingying Lu
Format: Article
Language:English
Published: IMR Press 2023-09-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009183
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author Libing Liu
Weiwei Wei
Huimin Tang
Yao Chen
Hong Zheng
Bin Tang
Ruxia Shi
Jiming Chen
Bairong Xia
Bingying Lu
author_facet Libing Liu
Weiwei Wei
Huimin Tang
Yao Chen
Hong Zheng
Bin Tang
Ruxia Shi
Jiming Chen
Bairong Xia
Bingying Lu
author_sort Libing Liu
collection DOAJ
description Background: To evaluate the clinical efficacy and safety of the modified laparoscopic inverted triangle model for extended lesion resection in treating dysmenorrhea focal adenomyosis in women who have completed childbirth. Methods: A total of 52 patients with dysmenorrhea focal adenomyosis treated in the Department of Gynecology of the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University from July 2014 to August 2020 were retrospectively analyzed. They underwent the modified laparoscopic inverted triangle model for extended lesion resection. The scope of resection included the focal adenomyosis lesions and along with part of the surrounding normal myometrial tissue and endometrium in order to ensure full resection of adenomyosis lesions without residual. Surgical outcome and adverse effects on ovarian functions were evaluated through the retrospective analysis compared the changes of dysmenorrhea visual analog scale (VAS) score changes, uterine volume changes, changes in serum CA125 level, and serum anti-mullerian hormone (AMH) level changes prior to surgery as well as 3, 6, 12, and 24 months after surgery. Results: All operations were completed by laparoscopy without conversion to laparotomy. No serious complications occurred during or after surgery. The dysmenorrhea VAS score, uterine volume, and serum CA125 level at 3, 6, 12, and 24 months after surgery were significantly lower than baseline and the difference was statistically significant. The serum AMH level showed a downward trend 3 months after surgery compared with the pre-surgery level, but the difference was not statistically significant (p = 0.27). The response rates at 3, 6, 12, and 24 months after surgery were 98.1%, 98.1%, 96.1%, and 88.5%, respectively, and the complete response rates were 30.8%, 34.6%, 34.6%, and 21.1%, respectively. Conclusions: Modified laparoscopic inverted triangle model for extended lesion resection is a safe and effective conservative surgical method for treating dysmenorrhea focal adenomyosis.
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spelling doaj-art-9a712fb4567941f887c1d793cb068e2f2025-08-20T03:36:53ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-09-0150918310.31083/j.ceog5009183S0390-6663(23)02139-5Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed ChildbirthLibing Liu0Weiwei Wei1Huimin Tang2Yao Chen3Hong Zheng4Bin Tang5Ruxia Shi6Jiming Chen7Bairong Xia8Bingying Lu9Department of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDivision of Life Sciences and Medicine, Department of Gynecology, The First Affiliated Hospital of the University of Science and Technology of China, University of Science and Technology of China, 230031 Hefei, Anhui, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDivision of Life Sciences and Medicine, Department of Gynecology, The First Affiliated Hospital of the University of Science and Technology of China, University of Science and Technology of China, 230031 Hefei, Anhui, ChinaDepartment of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaBackground: To evaluate the clinical efficacy and safety of the modified laparoscopic inverted triangle model for extended lesion resection in treating dysmenorrhea focal adenomyosis in women who have completed childbirth. Methods: A total of 52 patients with dysmenorrhea focal adenomyosis treated in the Department of Gynecology of the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University from July 2014 to August 2020 were retrospectively analyzed. They underwent the modified laparoscopic inverted triangle model for extended lesion resection. The scope of resection included the focal adenomyosis lesions and along with part of the surrounding normal myometrial tissue and endometrium in order to ensure full resection of adenomyosis lesions without residual. Surgical outcome and adverse effects on ovarian functions were evaluated through the retrospective analysis compared the changes of dysmenorrhea visual analog scale (VAS) score changes, uterine volume changes, changes in serum CA125 level, and serum anti-mullerian hormone (AMH) level changes prior to surgery as well as 3, 6, 12, and 24 months after surgery. Results: All operations were completed by laparoscopy without conversion to laparotomy. No serious complications occurred during or after surgery. The dysmenorrhea VAS score, uterine volume, and serum CA125 level at 3, 6, 12, and 24 months after surgery were significantly lower than baseline and the difference was statistically significant. The serum AMH level showed a downward trend 3 months after surgery compared with the pre-surgery level, but the difference was not statistically significant (p = 0.27). The response rates at 3, 6, 12, and 24 months after surgery were 98.1%, 98.1%, 96.1%, and 88.5%, respectively, and the complete response rates were 30.8%, 34.6%, 34.6%, and 21.1%, respectively. Conclusions: Modified laparoscopic inverted triangle model for extended lesion resection is a safe and effective conservative surgical method for treating dysmenorrhea focal adenomyosis.https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009183focal adenomyosisdysmenorrheamodified laparoscopic inverted triangle modelextended lesion resectionconservative surgery
spellingShingle Libing Liu
Weiwei Wei
Huimin Tang
Yao Chen
Hong Zheng
Bin Tang
Ruxia Shi
Jiming Chen
Bairong Xia
Bingying Lu
Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
Clinical and Experimental Obstetrics & Gynecology
focal adenomyosis
dysmenorrhea
modified laparoscopic inverted triangle model
extended lesion resection
conservative surgery
title Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
title_full Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
title_fullStr Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
title_full_unstemmed Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
title_short Modified Laparoscopic Inverted Triangle Model for Extended Lesion Resection in the Treatment of Symptomatic Localized Adenomyosis in Women Who Have Completed Childbirth
title_sort modified laparoscopic inverted triangle model for extended lesion resection in the treatment of symptomatic localized adenomyosis in women who have completed childbirth
topic focal adenomyosis
dysmenorrhea
modified laparoscopic inverted triangle model
extended lesion resection
conservative surgery
url https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009183
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