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Multicenter Study
. 2023 Mar-Apr;37(2):756-762.
doi: 10.21873/invivo.13138.

Clinical and Surgical Characteristics of Abdominal Wall Endometriosis: A Multicenter Case Series of 80 Women

Elvin Piriyev  1   2 , Ahmet Namazov #  3   4 , Islam Mahalov #  5 , Aygul Mamedova  5 , Ofer Gemer  3   4 , Sven Schiermeier  2 , Thomas Römer  6
Affiliations
Multicenter Study

Clinical and Surgical Characteristics of Abdominal Wall Endometriosis: A Multicenter Case Series of 80 Women

Elvin Piriyev et al. In Vivo. 2023 Mar-Apr.

Abstract

Background/aim: Endometriosis of the abdominal wall (AWE) is poorly understood because of its rarity and heterogeneous nature. The aim of this study was to investigate and present the clinical and surgical characteristics of AWE and to propose its classification.

Patients and methods: This was a multicentric retrospective study. For this analysis, the data from three endometriosis centers were collected. In total 80 patients were included in this study. The Academic Hospital Cologne Weyertal is a certified, level III endometriosis center in Germany with 750-1,000 endometriosis surgeries being performed annually; Barzilai University Medical Center is a certified endometriosis center in Ashkelon, Israel; and Baku Health Center is an endometriosis Center in Baku, Azerbaijan.

Results: The size of nodule (histological specimen) was significant larger in women with than those without adenomyosis (3.34±1.4 vs. 2.55±1.33 cm, p=0.016). The incidence of subfascial involvement was also found to be significantly higher in these women (42% vs. 19%, p=0.03). No significant difference was found in patients with and without obesity. In 78% of cases, the proliferation level (Ki67 marker) was less than 30%.

Conclusion: AWE has a high prevalence of symptoms such as abdominal wall pain and swelling, as well as bleeding. The strengths of the current study are the investigation of the proliferation marker Ki67 in AWE, the impact of adenomyosis, as well as the suggested classification.

Keywords: Abdominal wall endometriosis; caesarean scar endometriosis; classification of abdominal wall endometriosis; extrapelvic endometriosis; umbilical endometriosis.

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Conflict of interest statement

The Authors have no conflicts of interest in this work.

Figures

Figure 1
Figure 1. Postoperative imaging of resected abdominal wall endometriosis with internal fibrotic changes.
See this image and copyright information in PMC

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