{"id":260,"title":"Perioperative Morbidity and Recurrence After One-Stage Laparoscopic Resection for Multicompartment Deep Endometriosis: A Multicentre Cohort Study","title_zh":"多腔室深部子宫内膜异位症一期腹腔镜切除的围手术期并发症与复发：多中心队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42972913","doi":"10.1111/1471-0528.70366","pmid":"42972913","journal":"BJOG","kind":"paper","lang":"en","published_at":"2026-11-02T00:00:00+00:00","fetched_at":"2026-11-08T03:44:00+00:00","authors":["Pagano F","Sík PB","Imboden S","Bokor A","Mueller MD"],"primary_topic":"endometrium","topics":[{"slug":"endometrium","score":4.0,"hits":["endometriosis"]}],"topic_score":4.0,"preference_score":0.0,"preference_labels":[],"llm_score":76.0,"final_score":80.0,"score_dims":{"novelty":62,"rigor":85,"impact":68,"relevance":58,"translation":74},"recommend_reason":"大样本多中心数据支持#ENZIAN整体解剖范围预测深部内异症一期手术并发症，对生育相关内异症术前咨询和手术决策有直接参考价值；但属回顾性观察，对ART/胚胎实验室的直接推动有限。","keywords":["深部子宫内膜异位症","#ENZIAN","腹腔镜手术","围手术期并发症","复发","多中心队列"],"selected":1,"story_id":192,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-uterus-pregnancy","source_name":"PubMed · 内膜/植入/早孕","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":"bjog","journal_tier":"field-top","journal_if":4.7,"is_mock":false,"summary_zh":"多中心回顾性队列纳入2017–2025年两家三级中心299例病理确诊的深部子宫内膜异位症患者，均行多腔室病变一期腹腔镜切除。以Clavien-Dindo≥II级定义临床相关并发症。术后并发症36例（12.0%），≥IIIb级14例（4.7%）；#ENZIAN解剖范围每增加一个受累腔室，并发症风险独立升高（aOR 1.51）。复发43例（14.4%），26例再手术；肠管或膀胱手术方式与无复发生存无显著差异。结论：整体解剖范围比单一部位受累更能反映手术复杂性，可用于术前咨询和个体化手术规划。","summary":"OBJECTIVE: To evaluate perioperative morbidity, factors associated with postoperative complications and documented recurrence after one-stage laparoscopic resection for multicompartment deep endometriosis. DESIGN: Retrospective multicentre cohort study. SETTING: Two tertiary referral centres specialised in endometriosis surgery (Bern, Switzerland; Budapest, Hungary). POPULATION: A total of 299 consecutive patients with pathologically confirmed deep endometriosis undergoing one-stage laparoscopic resection between January 2017 and December 2025. INTERVENTIONS: One-stage laparoscopic resection of multicompartment deep endometriosis. MEASUREMENTS AND MAIN RESULTS: Clinically relevant postoperative complications were defined as Clavien-Dindo Grade ≥ II. Multivariable logistic regression assessed associated factors. Recurrence-free survival was evaluated using Kaplan-Meier analysis in patients with an available recurrence time or censoring time. Postoperative complications occurred in 36/299 patients (12.0%), including 35/299 (11.7%) with Grade ≥ II complications and 14/299 (4.7%) with Grade ≥ IIIb complications. Greater #ENZIAN deep endometriosis anatomical extent was independently associated with clinically relevant complications (adjusted odds ratio 1.51 per additional involved compartment, 95% confidence interval 1.04-2.18). Documented recurrence occurred in 43/299 patients (14.4%) and 26/299 (8.7%) underwent reoperation for recurrence. Follow-up duration was available for 231/299 patients (77.3%). Recurrence-free survival did not differ significantly according to bowel (log-rank p = 0.431) or bladder surgical technique (p = 0.116). CONCLUSION: Greater #ENZIAN deep endometriosis anatomical extent was independently associated with clinically relevant postoperative complications following one-stage surgery for multicompartment deep endometriosis, suggesting that overall anatomical disease extent may better reflect surgical complexity than involvement of a single anatomical site. These findings support the role of anatomical disease extent in preoperative counselling and individualised surgical planning.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}