尽管膀胱切除术仍然是子宫内膜异位症手术治疗的金标准，但对卵巢储备功能负面影响的担忧正在增加。子宫内膜异位症的激光 CO2 汽化术在卵巢储备功能保存、术后妊娠率和复发方面显示出令人鼓舞的数据。本研究的目的是评估手术后至少 5 年后采用 CO2 光纤激光汽化治疗的子宫内膜异位症患者的术后复发率和妊娠率。回顾性研究。意大利三级中心，2023 年 10 月至 2024 年 2 月。我们纳入了年龄 > 18 岁接受腹腔镜 CO2 光纤激光汽化术治疗子宫内膜异位症。年龄≥40岁、既往卵巢手术、既往输卵管切除术或子宫切除术、子宫内膜异位症组织学结果阴性或组织学发现任何恶性肿瘤均为排除标准。卵巢子宫内膜异位瘤通过腹腔镜CO2光纤激光汽化。手术后，患者被纳入定期临床随访的监测计划。其中包括 78 名患者。平均年龄为33.2±4.6岁，基础AMH为2.7±1.9ng/mL，子宫内膜异位囊肿中位直径为4(3-5)cm。中位随访时间为72.5个月（67-84.5）。手术后，有生育意愿的女性中65.5%（n=36）成功怀孕，其中55.6%自然怀孕，44.4%通过辅助生殖技术成功怀孕，平均怀孕时间为17.7±18.1个月。 7 名同侧复发患者的 Kaplan-Meier 曲线显示，中位复发时间为 26 个月，100 个月时估计无病患者率为 91.03%（95% CI 82.10%-95.62%）。 CO2 光纤激光汽化术是一种有效且安全的卵巢子宫内膜异位症手术治疗方法，结合了保留卵巢组织技术的优势和与膀胱切除术文献中描述的长期术后复发率相当的优势。版权所有 © 2024。已发布由爱思唯尔公司

Although cystectomy remains the gold standard for the surgical treatments of endometriomas, concerns about the negative effect on ovarian reserve are rising. Laser-CO2 vaporization of endometriomas has showed encouraging data on ovarian reserve preservation, postoperative pregnancy rates and recurrency. The aim of this study was to assess postoperative recurrence rate and pregnancy rate in patients with endometriomas managed by CO2 fiber laser vaporization after at least 5 years following surgery.Retrospective study.Italian tertiary center from October 2023 to February 2024.We included women aged >18 years who underwent laparoscopic CO2 fiber laser vaporization for endometriomas. Age ≥ 40 years, previous ovarian surgery, previous salpingectomy or hysterectomy, negative histologic finding for endometriosis or any findings of malignancy at histology were exclusion criteria.Ovarian endometriomas were vaporized through laparoscopic CO2 fiber laser. After surgery, patients were included in a surveillance program with periodic clinical follow-up.Seventy-eight patients were included. The mean age was 33.2±4.6 years, the basal AMH was 2.7 ± 1.9 ng/mL and the median diameter of the endometriomas was 4(3-5)cm. The median duration of follow-up was 72.5 months(67-84.5). After surgery, 65.5%(n=36) of women with reproductive desire achieved a pregnancy, 55.6% spontaneously and 44.4% through Assisted Reproduction Techniques, with a mean time to pregnancy of 17.7±18.1 months. A Kaplan-Meier curve for the 7 patients who experienced an ipsilateral recurrence showed that the median time to recurrence was 26 months and the estimated rate of disease-free patients was 91.03% at 100 months (95% CI 82.10%-95.62%).CO2 fiber laser vaporization is an effective and safe surgical treatment of ovarian endometriomas, combining the advantage of being an ovarian tissue-sparing technique with long-term post-operative recurrence rate comparable with that described in literature for the cystectomy.Copyright © 2024. Published by Elsevier Inc.