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复发是子宫内膜异位症(endometriosis,EM,内异症)临床诊治中常见、难以处理、需管理的一项重要问题。深部浸润型内异症(deeply infiltrating endometriosis,DIE)经彻底切除后很少复发,前次手术残留的病灶被认为是复发的主要原因。复发的患者盆腔粘连严重、病灶侵入深,手术并发症多,为再次手术增加了极大的难度,对于术者的技术水平要求则更高。因此,二次手术必须基于细致的风险、收益评估方可实施。加强术前及术后各个环节治疗方案的评估,强调有计划的终身管理。
Recurrence is one of the most common, difficult to handle and manageable problems in the clinical diagnosis and treatment of endometriosis (EM). Deeply infiltrating endometriosis (DIE) rarely relaps after radical resection and the residual lesions of the previous surgery are considered to be the primary cause of recurrence. Patients with recurrent pelvic adhesions serious, deep invasion of the lesion, surgical complications and more for re-surgery increased great difficulty for the surgeon’s technical level requirements are higher. Therefore, the second surgery must be based on detailed risk assessment of benefits before implementation. Strengthen preoperative and postoperative evaluation of treatment programs in all aspects, emphasizing planned life-long management.