[Clinical evaluation on laparoscopic diagnosis of pelvic endometriosis by heat-colour test with endocoagulation]

Abstract

Objective: To assess the value of heat-colour test (HCT) with endocoagulation under laparoscopy as a new method for diagnosis of pelvic endometriosis (EM).

Methods: Laparoscopic visible examination (LVE), lesion biopsy and HCT with endocoagulation were employed for diagnosis of EM in 83 cases of infertility. Brown-black colour changes of peritoneal tissue after endocoagulation with controlled heating (100 C) indicate EM implants (HCT positive).

Results: LVE indicated that 35 cases had peritoneal lesions typical of EM in appearance. HCT was positive in all cases of visible EM lesions. 48 cases showed no visible peritoneal lesions by LVE, but nonpigmented peritoneal EM lesions were detected by HCT in 20 of the 48 cases. A variety of gross appearances of nonpigmented EM lesions were found in our study including: peritoneal hyperemia (70.9%), circular peritoneal defects (12.7%), semitransparant glandular excrescences (10.9%), white opacification of the peritoneum (10.9%) and normal appearance (5.4%). 25 biopsies were taken from nonpigmented peritoneal lesions in 13 cases. Histology examinations revealed the presence of EM in 64.0% of them.

Conclusions: HCT is a reliable, sensitive and accurate method for diagnosis of EM. It can overcome multiple factors for missing diagnosis of EM by LVE and biopsy. The clinical significance of HCT is its ability to detect nonpigmented endometriotic lesions, to differentiate the causes of pelvic adhesions, therefore to increase accuracy of FIGO EM staging under laparoscopy.