Objective

To assess the prevalence of endometriosis of the appendix and the association with other pelvic localizations of the disease and to provide pathogenesis hypotheses.

Methods

Monocentric, observational, retrospective, cohort study. Patients undergoing laparoscopic endometriosis surgery in our tertiary referral center were consecutively enrolled. The prevalence of the different localizations of pelvic endometriosis including appendix involvement detected during surgery was collected. Included patients were divided into two groups based on the presence of appendiceal endometriosis. Women with a history of appendectomy were excluded.

Measurements and main results.

Four hundred-sixty patients were included for data analysis. The prevalence of appendiceal endometriosis was 2.8%. In patients affected by endometriosis of the appendix, concomitant ovarian and/or bladder endometriosis were more frequently encountered, with prevalence of 53.9% (vs 21.0% in non-appendiceal endometriosis group, p = 0.005) and 38.4% (vs 11.4%, p = 0.003), respectively. Isolated ovarian endometriosis was significantly associated to appendiceal disease compared to isolated uterosacral ligament (USL) endometriosis or USL and ovarian endometriosis combined (46.2% vs 15.4% vs 7.7%, p < 0.001). Poisson regression analysis revealed a 4.1-fold and 4.4-fold higher risk of ovarian and bladder endometriosis, respectively, and a 0.1-fold risk of concomitant USL endometriosis in patients with appendiceal involvement.

Conclusion

Involvement of the appendix is not uncommon among patients undergoing endometriosis surgery. Significant association was detected between appendiceal, ovarian, and bladder endometriosis that may be explained by disease dissemination coming from endometrioma fluid shedding. Given the prevalence of appendiceal involvement, counseling regarding the potential need for appendectomy during endometriosis surgery should be considered.

中文翻译：

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阑尾子宫内膜异位症：患病率、相关病变和发病机制假设的提出。使用前瞻性收集的数据进行回顾性队列研究

 客观的

评估阑尾子宫内膜异位症的患病率以及与该疾病其他盆腔部位的关联，并提供发病机制假设。

 方法

单中心、观察性、回顾性、队列研究。连续纳入在我们三级转诊中心接受腹腔镜子宫内膜异位症手术的患者。收集了盆腔子宫内膜异位症不同部位的患病率，包括手术期间检测到的阑尾受累。根据是否存在阑尾子宫内膜异位症将纳入的患者分为两组。有阑尾切除史的女性被排除在外。

测量和主要结果。

四百六十名患者被纳入数据分析。阑尾子宫内膜异位症的患病率为2.8%。在受阑尾子宫内膜异位症影响的患者中，更常见伴随卵巢和/或膀胱子宫内膜异位症，患病率为 53.9%（对比非阑尾子宫内膜异位症组的 21.0%，p = 0.005）和 38.4%（对比 11.4%，p） = 0.003），分别。与孤立性子宫骶韧带 (USL) 子宫内膜异位症或 USL 和卵巢子宫内膜异位症组合相比，孤立性卵巢子宫内膜异位症与阑尾疾病显着相关（46.2% vs 15.4% vs 7.7%，p < 0.001）。泊松回归分析显示，阑尾受累患者患卵巢和膀胱子宫内膜异位症的风险分别高出 4.1 倍和 4.4 倍，同时发生 USL 子宫内膜异位症的风险高出 0.1 倍。

 结论

在接受子宫内膜异位症手术的患者中，阑尾受累并不罕见。在阑尾、卵巢和膀胱子宫内膜异位症之间发现了显着的关联，这可能是由于子宫内膜异位症液体脱落引起的疾病传播造成的。鉴于阑尾受累的普遍性，应考虑就子宫内膜异位症手术期间是否需要阑尾切除术进行咨询。