Laparoscopic surgical treatment of diaphragmatic endometriosis: a 7-year single-institution retrospective review
Abstract
Background Diaphragmatic endometriosis is a rare condition that may cause invalidating epigastric or thoracic pain and catamenial pneumothorax. During the past decades, laparoscopy has been proposed as an optimal tool for diagnosis and surgical eradication of the disease. Methods We present a retrospective series of consecutive patients affected by diaphragmatic endometriosis, treated by laparoscopy at our institution, during a period of 7 years. Results Among 3,008 patients with pelvic endometriosis, 46 cases with intraoperative diagnosis of diaphragmatic endometriosis were identified. Operative findings showed multiple diaphragmatic lesions in 32 (69.5 %) patients and single lesions in 14 (30.4 %). Diaphragmatic implants were distributed on the right side in 40 (86.9 %) patients; in 5 patients (10.8 %) they were bilateral and 1 patient had a single lesion on the left hemidiaphragm. Most of the symptomatic patients were treated by complete excision of the nodules, whereas only three patients referring right upper-quadrant abdominal pain and right shoulder catamenial pain had superficial diaphragmatic endometriosis and were treated by diathermocoagulation. Conclusion Diaphragmatic endometriosis should be included in the concept of complete eradication of endometriosis. This kind of surgery has been shown to be feasible and cost-effective; however, it should be managed in a referral center, by an expert laparoscopic gynecologist with knowledge of oncological surgical techniques, with the support of a general surgeon and a trained anesthesiologist.
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For thoracic endometriosis, hormone treatment can be offered.
“For thoracic endometriosis, hormone treatment can be offered.”
From ESHRE guideline: endometriosis (2022) · cites this paper as Ceccaroni et al., 2013
Cites
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Pericardial, pleural, and diaphragmatic endometriosis
Ceccaroni, M., Clarizia, R., & Placci, A. (2010) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2010.07.064 · Cited by 19 · see citing works
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ESHRE guideline: endometriosis
Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F., Kiesel, L., King, K., Kvaskoff, M., Nap, A., Petersen, K., et al. (2022) · Human Reproduction Open · doi:10.1093/hropen/hoac009 · Cited by 1,712 · see citing works
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Self-citationMR diagnosis of diaphragmatic endometriosis
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Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management
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Ceccaroni, M., Roviglione, G., Farulla, A., Bertoglio, P., Clarizia, R., Viti, A., Mautone, D., Ceccarello, M., Stepniewska, A., & Terzi, A. C. (2021) · Surgical Endoscopy · doi:10.1007/s00464-020-08186-z · Cited by 24 · see citing works
Self-citationDiaphragmatic endometriosis and thoracic endometriosis syndrome: A review on diagnosis and treatment
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- Authors
- Ceccaroni, M., Roviglione, G., Giampaolino, P., Clarizia, R., Bruni, F., Ruffo, G., Patrelli, T. S., De Placido, G., & Minelli, L.
- Affiliations
- Sacred Heart Hospital (US)
- University of Naples Federico II (IT)
- University of Parma (IT)
- Corresponding author
- Ceccaroni, Marcello
- ORCID
- Venue
- Surgical Endoscopy
- Published
- 2012-09-06
- Volume
- 27
- Issue
- 2
- Pages
- 625-632
- ISSN
- 0930-2794 (ISSN-L)
- 1432-2218
- OpenAlex
- W1986278026
- Cited by
- 66
- References
- 5
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 7 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 1
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Surgical Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Keywords
- diaphragmatic endometriosis, laparoscopic surgery, catamenial pneumothorax, epigastric pain, chest pain, diathermocoagulation, right upper quadrant pain
- MeSH terms
- Adult, Diaphragm, Endometriosis, Female, Humans, Muscular Diseases, Laparoscopy, Retrospective Studies, Time Factors, Young Adult
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