Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial.

Autor: Keckstein JS; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany. julia.keckstein@mailbox.org.; Department of Obstetrics and Gynecology, Klinikum Starnberg, Oßwaldstr. 1, 82319, Starnberg, Germany. julia.keckstein@mailbox.org., Keckstein S; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany.; Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany., Brunecker K; Erbe Elektromedizin GmbH, Waldhoernlestr. 17, 72072, Tübingen, Germany., Neugebauer A; Erbe Elektromedizin GmbH, Waldhoernlestr. 17, 72072, Tübingen, Germany., Nüssle D; Erbe Elektromedizin GmbH, Waldhoernlestr. 17, 72072, Tübingen, Germany., Hoffmann S; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Andress J; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Neis F; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Scharpf M; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Enderle M; Erbe Elektromedizin GmbH, Waldhoernlestr. 17, 72072, Tübingen, Germany., Rothmund R; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany.; Praxis Im Frauenzentrum Lindenhofspital, 3012, Bern, Switzerland., Brucker SY; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Jun MW; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany., Kraemer B; Department of Women's Health, Tuebingen University Hospital, Calwerstr. 7, 72076, Tübingen, Germany.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2023 Jan; Vol. 307 (1), pp. 187-194. Date of Electronic Publication: 2022 Mar 13.
DOI: 10.1007/s00404-022-06473-9
Abstrakt: Purpose: Endometriosis is a benign, but potentially serious gynaecological condition in terms of abdominal pain and impaired fertility. Laparoscopic excision techniques are considered the therapeutic standard. HybridAPC is presented as a novel technique for the non-contact thermal ablation of peritoneal endometriosis with simultaneous protection of the underlying thermosensitive structures by creating a needle-free elevated fluid cushion which enables a safer exposure and distance, as well as potentially improved peritoneal conditioning prior to APC.
Methods: In this prospective randomized clinical trial, 39 patients with 132 superficial endometriotic lesions in total were treated with HybridAPC or sharp excision in an initial laparoscopic procedure according to randomization. In a second-look laparoscopy, adhesion formation was rated macroscopically. Histologic samples were taken from previously treated areas for evaluation of eradication rate.
Results: The eradication rate was not significantly different between HybridAPC treatment and sharp excision (65 vs. 81%, p = .55). Adhesions formed in 5% of HybridAPC-treated lesions and in 10% after sharp excision (p = .49). HybridAPC treatment was significantly faster than sharp excision (69 vs. 106 s, p < .05). No intra- and postoperative complications were registered.
Conclusion: This clinical trial demonstrates the feasibility of this novel surgical technique with a promising impact on adhesion prevention. Compared to sharp excision, HybridAPC is likely to be a safe, tissue-preserving, and fast method for the treatment of peritoneal endometriosis.
(© 2022. The Author(s).)
Databáze: MEDLINE
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