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| Analysis of the influencing factors of the recurrence of adenomyosis of patients after laparoscopic surgery and discussion of the predictive indexes for the recurrence of adenomyosis |
| 1. The Fourth Clinical School of Medicine, Zhejiang University of Traditional Chinese Medicine Hangzhou, Zhejiang Province, 310000；2. Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang Province |
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Abstract To observe the influencing factors of the recurrence of adenomyosis (AM) of patients after laparoscopic surgery, and to discuss the predictive indexes for the recurrence of AM. Methods: The clinical data of 98 patients who had accepted laparoscopic AM focus resection in hospital from September 2018 to September 2020 were analyzed retrospectively, and the recurrence of AM of these patients was observed in 2 years of follow up after the operation. Multivariate logistic regression was used to analyze the influencing factors of the AM recurrence of these patients. The efficacy of the influencing factors of the patients for predicting their postoperative AM recurrence was analyzed by receiver operator characteristic (ROC) curve. Results: Among 98 patients, there were 17 cases with the recurred AM within 2 years after laparoscopic AM surgery, and the recurrence rate was 17.4%. Univariate analysis showed that the age, the dysmenorrhea VAS score, the uterine volume, the AM lesion type, and the postoperative GnRH-a used of the patients were correlated with their postoperative AM recurrence (P＜0.05). Multivariate analysis showed that the age <35 years old, the VAS score ≥7 points, and the uterine volume ≥200 cm3 of the patients were all the independent risk factors for their AM recurrence (P＜0.05). The AM lesion type and the postoperative GnRH-a used of the patients were non-independent risk factors for their postoperative recurrence (P>0.05). ROC curve analysis showed that age, the dysmenorrhea VAS score, and the uterine volume of the patients had certain predictive values for their AM recurrence after laparoscopic surgery, and the area under the curve of which were 0.632, 0.655, and 0.682, respectively. Conclusion: The juvenility, the high dysmenorrhea VAS score, and the large uterine volume of the patients are all the influence factors of their AM recurrence after laparoscopic surgery, and which have certain predictive values for the AM recurrence. However, the postoperative GnRH-a application has no influent on the AM recurrence of the patients. So the targeted preventing the AM recurrence should be conducted in clinic.
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