Janelle K Moulder1,2, Matthew T Siedhoff3, Kathryn L Melvin4, Elizabeth G Jarvis5, Kumari A Hobbs6, Joanne Garrett7. 1. Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA. 2. University of Tennessee Medical Center, Knoxville, TN, USA. 3. Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 4. Yale School of Nursing, New Haven, CT, USA. 5. Department of Obstetrics and Gynecology, WakeMed Physician Practices, Raleigh, NC, USA. 6. Department of Obstetrics and Gynecology, New York-Presbyterian/Lower Manhattan Hospital, New York, NY, USA. 7. Division of Family Planning, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Abstract
OBJECTIVE: To determine whether deep-infiltrating endometriosis (DE) carries an increased risk of appendiceal endometriosis (AppE) as compared with superficial endometriosis or no endometriosis. METHODS: In a retrospective study, data were obtained by chart review of an internal database for women who underwent coincidental appendectomy during benign gynecologic surgery between July 2009 and February 2014 at a tertiary referral center in the USA. Univariate, bivariate, and regression analyses were performed. The primary exposure was surgically documented endometriosis (DE, superficial, or no endometriosis). The primary outcome was AppE. RESULTS: Endometriosis was diagnosed for 151 (38.2%) of 395 women; 82 (54.3%) had DE. The prevalence of AppE was 13.2% (52/395) overall; 8 (11.6%) of 69 women with superficial endometriosis and 32 (39.0%) of 82 with DE were affected. Frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all P<0.001). Women with DE had a 5.9-fold (95% confidence interval [CI] 2.9-11.9) higher risk of AppE compared with women without endometriosis, controlling for appendiceal appearance and surgical indication, and a 2.7-fold (95% CI 1.2-6.2) higher risk of AppE compared with those with superficial endometriosis. CONCLUSION: Women with DE have increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients.
OBJECTIVE: To determine whether deep-infiltrating endometriosis (DE) carries an increased risk of appendiceal endometriosis (AppE) as compared with superficial endometriosis or no endometriosis. METHODS: In a retrospective study, data were obtained by chart review of an internal database for women who underwent coincidental appendectomy during benign gynecologic surgery between July 2009 and February 2014 at a tertiary referral center in the USA. Univariate, bivariate, and regression analyses were performed. The primary exposure was surgically documented endometriosis (DE, superficial, or no endometriosis). The primary outcome was AppE. RESULTS:Endometriosis was diagnosed for 151 (38.2%) of 395 women; 82 (54.3%) had DE. The prevalence of AppE was 13.2% (52/395) overall; 8 (11.6%) of 69 women with superficial endometriosis and 32 (39.0%) of 82 with DE were affected. Frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all P<0.001). Women with DE had a 5.9-fold (95% confidence interval [CI] 2.9-11.9) higher risk of AppE compared with women without endometriosis, controlling for appendiceal appearance and surgical indication, and a 2.7-fold (95% CI 1.2-6.2) higher risk of AppE compared with those with superficial endometriosis. CONCLUSION:Women with DE have increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients.
Authors: Rogério Serafim Parra; Marley Ribeiro Feitosa; Giovana Bachega Badiale Biagi; Daniel Ferracioli Brandão; Margarida Maria Fernandes da Silva Moraes; Liliane Silvestre; José Vitor Cabral Zanardi; Nelson Hitamo Sato Junior; Omar Féres; José Joaquim Ribeiro da Rocha Journal: J Med Case Rep Date: 2020-09-14