Preventable surgical complication: insights from 33 abdominal wall endometriosis cases

Yıl 2025, Cilt: 50 Sayı: 3, 944 - 948, 30.09.2025

Güven Erdoğrul , Güvenç Diner , Samed Sayar , Hacer Ece Özcan , Tuna Ayas

https://doi.org/10.17826/cumj.1665736

https://izlik.org/JA37AN95AC

Öz

Purpose: The aim of this study was to report the diagnosis, treatment and follow-up results of patients operated with the diagnosis of abdominal wall endometriosis and to investigate its preventability.
Materials and Methods: This retrospective study included 33 patients who underwent surgery for abdominal wall endometriosis between 2021 and 2024. Diagnostic processes, treatment and follow-up results of the patients were evaluated. Patients were analyzed in terms of age, during from the last pelvic surgery to endometriosis excision, endometriosis location, endometriosis size, mesh use and recurrence.
Results: 33 patients were included in the study and the mean age was 32.91±5.64 years. Endometriosis lesions were detected at the Pfannenstiel incision line in all patients, 32 of them had a history of cesarean section and 1 patient had a history of oophorectomy. The lesions were located in the right corner in 19 patients, in the left corner in 12 patients and in the midline of the incision line in 2 patients. Follow-up period was 47.24±25.07 months and no recurrence or hernia was observed in any of the patients.
Conclusion: Abdominal wall endometriosis is a preventable complication, and it is necessary to avoid using the remaining vicryl in the fascia during uterine closure during cesarean section and to prevent intraoperative contamination.

Anahtar Kelimeler

Caesarean , Endometriosis , Excision

Etik Beyan

Ethical permission was obtained from the Mersin University, Medical Faculty Clinical Research Ethics Committee for this study with date 27/11/2024 and number 2024/1160.

Destekleyen Kurum

No financial support was used by authors during this study.

Önlenebilir cerrahi bir komplikasyon: 33 karın duvarı endometriozis olgusunun bulguları

https://izlik.org/JA37AN95AC

Öz

Amaç: Bu çalışmda karın duvarı endometriozisi tanısı ile opere edilen hastaların tanı, tedavi ve takip sonuçlarını bildirmek ve önlenebilirliğini araştırmak amaçlandı.
Gereç ve Yöntem: Bu retrospektif çalışmaya 2021 ile 2024 tarihleri arasında karın duvarı endometriozisi tanısı ile opere edilen 33 hasta dahil edildi. Hastaların tanı süreçleri, tedavi ve takip sonuçları değerlendirildi. Hastaların yaş, son pelvik cerrahiden endometriozis eksizyonuna kadar geçen süre, endometriozis yerleşim yeri, endometriozis büyüklükleri, mesh kullanımı ve nüks durumu açısından analiz edildi.
Bulgular: Çalışmaya 33 hasta dahil edilmiştir ve yaş ortalaması 32,91±5,64 yıl olarak hesaplandı. Hastaların hepsinde endometriozis lezyonları Pfannenstiel insizyonu hattında tespit edilmiştir ve 32’sinin öyküsünde sezaryen, 1 hastanın öyküsünde ise ooferektomi mevcuttu. Lezyonların yerleşimi incelendiğinde; 19 hastada sağ köşede, 12 hastada sol köşede ve 2 hastada insizyon hattının orta hattında olduğu belirlenmiştir. Takip süresi 47,24±25,07 ay olan hastaların hiçbirinde nüks ve herni izlenmedi.
Sonuç: Karın duvarı endometriozisi önlenebilir bir komplikasyon olup, sezaryen sırasında uterus kapatılmasında kullanılan ve kalan vikrilin fasyada kullanılmaması ve intraoperatif kontaminasyonun önlenmesi gerekmektedir.

Anahtar Kelimeler

Eksizyon , Endometriozis , Sezeryan

Kaynakça

• Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15:666-82.
• Falcone T, Flyckt R. Clinical management of endometriosis. Obstet Gynecol. 2018;131:557-71.
• Morales Martínez C, Tejuca Somoano S. Abdominal wall endometriosis. Am J Obstet Gynecol. 2017;217:701-2.
• Leite GK, Carvalho LF, Korkes H, Guazzelli TF, Kenj G, Viana Ade T. Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature. Sao Paulo Med J. 2009;127:270-7.
• Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases. Am J Surg. 2008;196:207-12.
• Zhong Q, Qin S, Lai H, Yao S, Chen S. Risk factors for postoperative recurrence of cesarean scar endometriosis. AJOG Glob Rep. 2024;4:100349.
• Zhang P, Sun Y, Zhang C, Yang Y, Zhang L, Wang N et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Womens Health. 2019;19:14.
• Yang E, Chen GD, Liao YH. Spontaneous abdominal wall endometriosis: A case report and review of the literature. Taiwan J Obstet Gynecol. 2023;62:155-7.
• Teng CC, Yang HM, Chen KF, Yang CJ, Chen LS et al. Abdominal wall endometriosis: an overlooked but possibly preventable complication. Taiwan J Obstet Gynecol. 2008;47:42-8.
• Carsote M, Terzea DC, Valea A, Gheorghisan-Galateanu AA. Abdominal wall endometriosis (a narrative review). Int J Med Sci. 2020;17:536-42.
• Youssef AT. The ultrasound of subcutaneous extrapelvic endometriosis. J Ultrason. 2020;20:e176-80.
• Doroftei B, Armeanu T, Maftei R, Ilie OD, Dabuleanu AM, Condac C. Abdominal wall Endometriosis: Two case reports and literature review. Medicina (Kaunas). 2020;56:727.
• Miller DM, Schouls JJ, Ehlen TG. Clear cell carcinoma arising in extragonadal endometriosis in a caesarean section scar during pregnancy. Gynecol Oncol. 1998;70:127-30.
• Razakamanantsoa L, Bodard S, Najdawi M, Dabi Y, Bendifallah S, Touboul C et al. Surgical and percutaneous image-guided therapies of abdominal wall endometriosis: a systematic review of current evidence. J Minim Invasive Gynecol. 2024;31:726-37.
• Liu G, Wang Y, Chen Y, Ren F . Malignant transformation of abdominal wall endometriosis: A systematic review of the epidemiology, diagnosis, treatment, and outcomes. Eur J Obstet Gynecol Reprod Biol. 2021;264:363-7.
• Benedetto C, Cacozza D, de Sousa Costa D, Coloma Cruz A, Tessmann Zomer M, Cosma S et al. Abdominal wall endometriosis: Report of 83 cases. Int J Gynaecol Obstet. 2022;159:530-6.
• Matter M, Schneider N, McKee T. Cystadenocarcinoma of the abdominal wall following caesarean section: case report and review of the literature. Gynecol Oncol. 2003;91:438-43.
• Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6:e005671.
• Ananias P, Luenam K, Melo JP, Jose AM, Yaqub S, Turkistani A et al. Cesarean section: A potential and forgotten risk for abdominal wall endometriosis. Cureus. 2021;13:e17410.
• Bahrami F, Maheux-Lacroix S, Bougie O, Boutin A. Complications following surgeries for endometriosis: A systematic review protocol. PLoS One. 2023;18:e0285929.