Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes
Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year per...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/20/6455 |
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| author | Antoine Naem Argyrios Andrikos Alin Stefan Constantin Michael Khamou Dimitrios Andrikos Antonio Simone Laganà Rudy Leon De Wilde Harald Krentel |
| author_facet | Antoine Naem Argyrios Andrikos Alin Stefan Constantin Michael Khamou Dimitrios Andrikos Antonio Simone Laganà Rudy Leon De Wilde Harald Krentel |
| author_sort | Antoine Naem |
| collection | DOAJ |
| description | Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed with diaphragmatic endometriosis. The majority of patients had coexisting deep pelvic endometriosis. Cyclic upper abdominal pain was reported by 60.9% of patients, while cyclic chest and shoulder pain were reported by 43.5% and 34.8% of patients, respectively. Most patients were treated with laparoscopic lesion ablation, while 21.1% were treated with minimally invasive excision. The mean follow-up time was 23.7 months. Long-lasting resolution of the chest, abdominal, and shoulder pain occurred in 50%, 35.7%, and 25% of patients, respectively. Nonetheless, 78.9% of patients reported major improvement in their symptoms postoperatively. Significantly higher rates of postoperative shoulder, abdominal, and chest pain were observed in patients who received postoperative hormonal therapy compared with those who did not. All patients treated expectantly remained stable. Therefore, we recommend treating diaphragmatic endometriosis only in symptomatic patients. The risk of incomplete surgery should be minimized by a multidisciplinary diagnostic and therapeutic approach with a careful assessment of the diaphragm and the thoracic cavity. |
| first_indexed | 2024-03-10T21:10:48Z |
| format | Article |
| id | doaj.art-694d17562eb04bc5a015a77970bced3c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:10:48Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-694d17562eb04bc5a015a77970bced3c2023-11-19T16:51:22ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011220645510.3390/jcm12206455Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment OutcomesAntoine Naem0Argyrios Andrikos1Alin Stefan Constantin2Michael Khamou3Dimitrios Andrikos4Antonio Simone Laganà5Rudy Leon De Wilde6Harald Krentel7Department of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, 47053 Duisburg, GermanyDepartment of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, 47053 Duisburg, GermanyDepartment of Obstetrics and Gynecology, Albertinen Hospital, 22457 Hamburg, GermanyDepartment of Radiology, Bethesda Hospital Duisburg, 47053 Duisburg, GermanyDepartment of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, 47053 Duisburg, GermanyUnit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, ItalyClinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, Medical Campus University of Oldenburg, 26121 Oldenburg, GermanyDepartment of Obstetrics, Gynecology, Gynecologic Oncology and Senology, Bethesda Hospital Duisburg, 47053 Duisburg, GermanyDiaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed with diaphragmatic endometriosis. The majority of patients had coexisting deep pelvic endometriosis. Cyclic upper abdominal pain was reported by 60.9% of patients, while cyclic chest and shoulder pain were reported by 43.5% and 34.8% of patients, respectively. Most patients were treated with laparoscopic lesion ablation, while 21.1% were treated with minimally invasive excision. The mean follow-up time was 23.7 months. Long-lasting resolution of the chest, abdominal, and shoulder pain occurred in 50%, 35.7%, and 25% of patients, respectively. Nonetheless, 78.9% of patients reported major improvement in their symptoms postoperatively. Significantly higher rates of postoperative shoulder, abdominal, and chest pain were observed in patients who received postoperative hormonal therapy compared with those who did not. All patients treated expectantly remained stable. Therefore, we recommend treating diaphragmatic endometriosis only in symptomatic patients. The risk of incomplete surgery should be minimized by a multidisciplinary diagnostic and therapeutic approach with a careful assessment of the diaphragm and the thoracic cavity.https://www.mdpi.com/2077-0383/12/20/6455endometriosisdiaphragmlaparoscopyablationexcisionshoulder pain |
| spellingShingle | Antoine Naem Argyrios Andrikos Alin Stefan Constantin Michael Khamou Dimitrios Andrikos Antonio Simone Laganà Rudy Leon De Wilde Harald Krentel Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes Journal of Clinical Medicine endometriosis diaphragm laparoscopy ablation excision shoulder pain |
| title | Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes |
| title_full | Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes |
| title_fullStr | Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes |
| title_full_unstemmed | Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes |
| title_short | Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes |
| title_sort | diaphragmatic endometriosis a single center retrospective analysis of the patients demographics symptomatology and long term treatment outcomes |
| topic | endometriosis diaphragm laparoscopy ablation excision shoulder pain |
| url | https://www.mdpi.com/2077-0383/12/20/6455 |
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