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| Clinical efficacy of goserelin acetate sustained-release implant inserted after laparoscopic surgery for treating patients with ovarian endometriosis and analysis of related factors of postoperative recurrence of endometriosis |
| The Third People's Hospital of Chengdu, Chengdu, Sichuan Province, 610014 |
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Abstract To explore the effect of goserelin acetate sustained-release implant inserted or gestrinone used after laparoscopic surgery for treating patients with ovarian endometriosis, and to analyze the related factors of postoperative recurrence of endometriosis. Methods: 170 patients with ovarian endometriosis who had undergone laparoscopic surgery were included and were divided into two groups(85 cases in each group)according to the random number table method from January 2016 to October 2020. The patients in the control group were treated with gestrinone for 4 to 6 consecutive cycles, and the patients in the observation group were treated with goserelin acetate sustained-release implant for 4 to 6 consecutive cycles. The therapeutic effect, the serum reproductive hormones levels, and the main symptoms of the patients were compared between the two groups. The incidence of adverse reactions and the recurrence rate within 1year of follow up of the patients in the two groups were counted. Logistic multivariate analysis was used to analyze the related influencing factors of the recurrence of ovarian endometriosis. Results: The total efficacy(90.6%)of the patients in the observation group was significantly higher than that(77.7%)of the patients in the control group. The decrease ranges of the reproductive hormone levels of the patients in the observation group after 6 months of treatment were significantly higher than those of the patients in the control group. The scores of dysmenorrhea, dyspareunia, and pelvic pain of the patients in the observation group were significantly lower than those of the patients in the control group(all P＜0.05). The incidence of adverse reactions(18.8%)of the patients in the observation group had no significantly different from that(16.5%)of the patients in the control group(P＞0.05). The endometriosis recurrence rate within 1 year after operation(8.2%)of the patients in the observation group was significantly lower than that (25.9%)of the patients in the control group(all P＜0.05). Multivariate analysis showed that larger diameter of the largest cyst, the deep endometriosis, and the higher r-AFS score of the patients were the risk factors of their recurrence of ovarian endometriosis(P＜0.05), and the postoperative medication and pregnancy of the patients were the protective factors of their recurrence of ovarian endometriosis(P＜0.05). Conclusion: The effect of goserelin acetate sustained-release implant for treating patients with ovarian endometriosis after operation is better, and the value of which for preventing endometriosis recurrence is high. The patients with ovarian endometriosis of large cyst diameter, high r-AFS score, or deep lesion have the high risk of postoperative endometriosis recurrence.
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