ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG CỦA NHÓM BỆNH NHÂN U BUỒNG TRỨNG DẠNG LẠC NỘI MẠC TỬ CUNG ĐƯỢC ĐIỀU TRỊ PHẪU THUẬT NỘI SOI TẠI BỆNH VIỆN PHỤ SẢN HÀ NỘI TỪ NĂM 2019 – 2023

Abstract

Objective: Describe the clinical and paraclinical characteristics of patients with endometriotic ovarian cysts who underwent laparoscopic surgery at Hanoi Obstetrics and Gynecology Hospital from 2019 to 2023. Subjects and Methods: A cross-sectional descriptive study was conducted on a sample of 260 patients diagnosed with ovarian endometrioma and treated with laparoscopic surgery at Hanoi Obstetrics and Gynecology Hospital from January 1, 2019, to December 31, 2023. Results: A study of 260 patients revealed a mean age of 35.86 ± 8.1 years (P<0.001), with 194 cases (74.5%) falling within the 30–49 age group. Chronic pelvic pain and dysmenorrhea were the most common clinical symptoms, observed in 73.1% and 36.5% of cases, respectively. Menstrual pain increased in patients with unilateral or bilateral ovarian endometriotic cysts (58.1%). On physical examination, most masses had a firm consistency (56.5%). Limited or absent mobility was found in the majority of cases (49.6%). Most tumors had well-defined borders with the uterus (66.2%), while 16.2% showed varying degrees of uterine invasion. Pain on examination was present in 87.7% of patients with varying intensity. Unilateral ovarian endometriomas (right or left ovary) were observed in 68.1% of cases, while bilateral involvement accounted for 31.9%. Moderate to severe pain (grades II and III) was reported by 71.5% of patients, and 21.2% experienced severe pain (grade IV) associated with complications (P<0.001). The mean size of the surgically removed cysts was 71 ± 24 mm. Elevated serum CA-125 levels were found in 77.7% of patients with ovarian cysts, while HE4 screening tests remained within normal limits in 93.8% of cases. Conclusion: The primary clinical symptoms include chronic pelvic pain and dysmenorrhea. The average size of surgically removed cysts is 65 ± 7.2 mm. There is an increasing tendency for the cysts to adhere to and invade surrounding pelvic organs, which poses significant challenges during laparoscopic surgery. Elevated serum CA-125 levels are found in the majority of cases, highlighting its value in disease screening and follow-up.