Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes
Open accessAbstract
Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed with diaphragmatic endometriosis. The majority of patients had coexisting deep pelvic endometriosis. Cyclic upper abdominal pain was reported by 60.9% of patients, while cyclic chest and shoulder pain were reported by 43.5% and 34.8% of patients, respectively. Most patients were treated with laparoscopic lesion ablation, while 21.1% were treated with minimally invasive excision. The mean follow-up time was 23.7 months. Long-lasting resolution of the chest, abdominal, and shoulder pain occurred in 50%, 35.7%, and 25% of patients, respectively. Nonetheless, 78.9% of patients reported major improvement in their symptoms postoperatively. Significantly higher rates of postoperative shoulder, abdominal, and chest pain were observed in patients who received postoperative hormonal therapy compared with those who did not. All patients treated expectantly remained stable. Therefore, we recommend treating diaphragmatic endometriosis only in symptomatic patients. The risk of incomplete surgery should be minimized by a multidisciplinary diagnostic and therapeutic approach with a careful assessment of the diaphragm and the thoracic cavity.
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In a recent study by Naem et al., only 21% of patients who underwent surgical management of symptomatic diaphragmatic endometriosis complied with recommended post-operative hormonal therapy.
“In a recent study by Naem et al., only 21% of the patients’ who underwent surgical management of symptomatic diaphragmatic endometriosis complied with the recommended post-operative hormonal therapy [ 96 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [96]
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Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management
Nezhat, C., Amirlatifi, N., Najmi, Z., & Tsuei, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13247602 · Cited by 36 · see citing works
- Authors
- Naem, A., Andrikos, A., Constantin, A., Khamou, M., Andrikos, D., Laganà, A., De Wilde, R., & Krentel, H.
- Affiliations
- University of Bremen (DE)
- Evangelisches Krankenhaus Bethesda (DE)
- Albertinen Diakoniewerk (DE)
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo (IT)
- Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, Medical Campus University of Oldenburg, 26121 Oldenburg, Germany
- Corresponding author
- Naem, Antoine
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2023-10-11
- Volume
- 12
- Issue
- 20
- Pages
- 6455
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC10607902
- OpenAlex
- W4387529627
- Cited by
- 28
- References
- 44
- Citations by year
- 2026: 4 · 2025: 16 · 2024: 8
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS UniPA (University of Palermo) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- diaphragmatic endometriosis, deep infiltrating endometriosis, cyclic abdominal pain, postoperative hormonal therapy, postoperative pain, long-term treatment outcomes, surgical management
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