title: Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution.
abstract: OBJECTIVE
  To compare the outcomes of percutaneous image-guided cryoablation of symptomatic abdominal wall endometriosis (AWE) versus surgery alone.
  
  
  METHODS
  From 2004 to 2016, cryoablation or surgery alone was performed under local (n = 5) or general anaesthesia (n = 15) for AWE in a single institution in 7 (mean age, 36.1 years) and 13 (mean age, 31.9 years) patients, respectively. Fifteen lesions were treated by cryoablation (mean size, 2.3 cm; range, 0.5-7 cm) and 16 by surgery (2.5 cm; 1.1-3.4 cm). Tolerance, efficacy and patient and procedural characteristics were compared.
  
  
  RESULTS
  Median follow-up was 22.5 (range, 6-42) months after cryoablation and 54 (14-149) after surgery. The median procedure and hospitalisation durations were 41.5 min (24-66) and 0.8 days (0-1) after cryoablation, and 73.5 min (35-160) and 2.8 days (1-12 days) after surgery (both P = 0.01). Three patients (23.1%) had severe complications and nine aesthetic sequels (69.2%) after surgery, none after cryoablation (P = 0.05). The median 12- and 24-month symptom free-survival rates were 100% and 66.7% (95% CI, 5.4; 94.5) after cryoablation and 92% (55.3; 98.9) after surgery at both time points (P = 0.45).
  
  
  CONCLUSIONS
  Cryoablation presents similar effectiveness to surgery alone for local control of AWE while reducing hospitalisation duration and complications. Any aesthetic sequels were associated with the cryoablation treatment.
  
  
  CONCLUSIONS
  • Hospitalisation is shorter after cryoablation than after surgery of abdominal wall endometriosis. • A significantly lower rate of complications is observed after cryoablation compared to surgery. • Cryoablation of abdominal wall endometriosis presents similar effectiveness to surgery alone. • A significant reduction of pain is observed 6 months after treatment. • A significant reduction of abdominal wall endometriosis is observed at 6 months.
authors.affiliation: Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Maillot
authors.affiliation: Service de gynecologie, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Brun
authors.affiliation: Service de chirurgie, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dubuisson
authors.affiliation: Service de radiologie, Hôpital Tenon, APHP, 4 rue de la Chine, 75020, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bazot
authors.affiliation: Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Grenier
authors.affiliation: Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France. cornelisfrancois@gmail.com.|Service de radiologie, Hôpital Tenon, APHP, 4 rue de la Chine, 75020, Paris, France. cornelisfrancois@gmail.com.
authors.forename: François H
authors.initials: FH
authors.lastname: Cornelis
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000328:Adult; D003452:Cryosurgery / Q000379:methods*; D018572:Disease-Free Survival; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abdominal wall endometriosis; Cryoablation; Outcomes; Safety; Surgery