Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study.

Abstract:

STUDY OBJECTIVE:To compare the cost-effectiveness of ultrasound (US)-guided aspiration and ethanol sclerotherapy versus laparoscopic surgery for benign-appearing ovarian endometrioma. DESIGN:Prospective, cohort pilot study. SETTING:Multiple centers, Spain. PATIENTS:Forty patients with suspected ovarian endometrioma identified by US, with a maximum diameter of 35 to 100 mm, of whom 33 met inclusion criteria. INTERVENTIONS:The study group (n = 17) underwent US-guided aspiration plus sclerotherapy with ethanol, and the control group (n = 14) underwent laparoscopic cystectomy. MEASUREMENTS AND MAIN RESULTS:Recurrence, complications, and direct costs were compared. One of 17 sclerotherapy patients recurred (5.9%) compared with 4 of 14 laparoscopic surgery patients (28.6%) (odds ratio 0.18, 0.01-1.53). No serious adverse effects (Clavien-Dindo ≥ III) were observed in the sclerotherapy group; 1 patient in the surgery group had a Clavien-Dindo IIIb complication. Median hospital direct costs were significantly lower in the sclerotherapy group than those in the surgery group-266 euros versus 2189 euros. CONCLUSION:Ethanol sclerotherapy seems to be cost-effective for endometrioma and also appears to reduce complications. In this pilot study, recurrence was not higher than with conventional surgery.

authors

Garcia-Tejedor A,Martinez-Garcia JM,Candas B,Suarez E,Mañalich L,Gomez M,Merino E,Castellarnau M,Regueiro P,Carreras M,Martinez-Franco E,Carrarrach M,Subirats N,Barbera J,Gonzalez S,Climent M,Fernández-Montolí E,Ponce J

doi

10.1016/j.jmig.2019.08.036

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

1133-1140

issue

5

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(20)30164-3

journal_volume

27

pub_type

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