Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section

Over the past few decades, the rate of Cesarean Section (CS) delivery has been rising rapidly and the prevalence of CS-associated complications including Abdominal Wall Endometriomas (AWE) increases with each additional operation. The aim of this study was to evaluate the clinical characteristics, h...

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Bibliographic Details
Published in:	Annals of medicine and surgery Vol. 62; pp. 219 - 224
Main Authors:	Hasan, Abdulkarim, Deyab, Abdou, Monazea, Khaled, Salem, Abdoh, Futooh, Zahraa, Mostafa, Mahmoud A., Youssef, Ahmed, Nasr, Mohamed, Omar, Nasser, Rabaan, Ali A., Taie, Doha M.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-02-2021 Elsevier
Subjects:	Abdominal wall Cesarean section Cohort Study Endometriosis surgery Pathology Abdominal wall Pathology Endometriosis surgery Cesarean section
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Summary:	Over the past few decades, the rate of Cesarean Section (CS) delivery has been rising rapidly and the prevalence of CS-associated complications including Abdominal Wall Endometriomas (AWE) increases with each additional operation. The aim of this study was to evaluate the clinical characteristics, histopathological diagnostic role and surgical management of post-CS AWE through a retrospective case review. We calculated the incidence of AWE and reviewed all the patients underwent surgical removal of Post-CS AWE during the period of 2012–2018 who were diagnosed, treated and followed up for 2–8 years at our tertiary hospital. Thirty women with AWE were included. The main symptom in 2/3 of cases was cyclic pain and 4 cases (13.3%) had no symptoms. The mean interval between prior CS and appearance of symptoms was 55.2 months and the mean size of the excised mass was 42 mm. Free surgical margin was less than 9 mm in 9 patients (30%) but no recurrence was recorded among all the studied patients. Pre-operative FNAC diagnosis was performed for only 3 patients (10%) which helped in excluding other potential pathologies. The clinical–pathological agreement value for detection of the nature of the abdominal wall mass was 93.4%. Patients with suspected AWE should undergo preoperative cytological biopsy to exclude alternative diagnosis. Wide surgical excision with margin of less than 1 cm could be accepted especially in case of weak abdominal wall. More studies on the post-CS complications; risks, prevention, early detection and proper management should be encouraged. •The incidence of post-CS abdominal wall endometriosis (AWE) in our hospital is 0.21%.•Surgical excision of AWE with free margins of less than 1 cm could be acceptable.•Pathology examination is crucial for AWE after excision but not a preoperative tool.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2049-0801 2049-0801
DOI:	10.1016/j.amsu.2021.01.029