title: Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle.
abstract: OBJECTIVE
  In vitro studies demonstrated that implantation on membranes (peritoneum, amniotic membranes) can take place if there are defects on the surface of the membranes. If these mechanisms play a role for the development of endometriosis in vivo, then patients with surgical treatment of peritoneal endometriosis in the luteal phase must have a high recurrence rate.
  
  
  METHODS
  Retrospective analysis of operation charts and follow-up data.
  
  
  METHODS
  Department of gynecology, in a hospital-based endometriosis treatment center.
  
  
  METHODS
  Two hundred twenty premenopausal women.
  
  
  METHODS
  Laparoscopic treatment for peritoneal endometriosis, stage I and II by revised American Society for Reproductive Medicine guidelines.
  
  
  METHODS
  During the follow-up period of 2 years, symptoms and gynecological and sonographic findings were documented. In case of suspected recurrence a repeat laparoscopy with biopsy was performed to prove the recurrent endometriosis macroscopically and histologically.
  
  
  RESULTS
  The total recurrence rate after 2 years was 9.6%. The recurrence rate of group III (15%) was twice as high as those of group I (7%) and group II (8%), as indicated by subjective complaints, clinical findings, macroscopy, and histology; no differences were found between groups I and II.
  
  
  CONCLUSIONS
  Endoscopic surgery for the treatment of peritoneal endometriosis should not be performed in the luteal phase.
authors.affiliation: Department of Obstetrics and Gynaecology, Ammerland Clinic GmbH, Academic Teaching Hospital of the University of Göttingen, Westerstede, Germany. schweppe@ammerland-klinik.de
authors.forename: Karl-Werner
authors.initials: KW
authors.lastname: Schweppe
authors.forename: Dieter
authors.initials: D
authors.lastname: Ring
mesh_terms: D001706:Biopsy; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D005498:Follicular Phase; D006801:Humans; D010535:Laparoscopy; D008183:Luteal Phase; D008597:Menstrual Cycle; D010060:Ovulation; D010532:Peritoneal Diseases / Q000473:pathology / Q000601:surgery*; D017697:Premenopause; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome