Endométriose : évaluation du score échographique UBESS (Ultrasound-Based Endometriosis Staging System) dans la prédiction de la difficulté chirurgicale

Abstract : Introduction: Surgical management of endometriosis may require different levels of surgical skill which influences the orientation of the patient. The Ultrasound-Based Endometriosis Staging System (UBESS) is a score developed in 2016 to predict the difficulty of surgery. Objective: To study the correlation between UBESS score and two main surgical classifications in the literature. Material And Methods: Study performed at the reference center of Poissy, France, between July 2016 and December 2017. Patients who underwent prospective UBESS staging then operated of their endometriosis were included. The patients were classified according to the levels of surgical difficulty of the Royal College of Obstetricians and Gynecologists (RCOG) and the classification created by Chi et al. The criterion of judgment was the correlation between the UBESS stages and RCOG and CHI levels. In a second analysis, we determined the predictive value of the operative plan for items included in the systematic sonographic evaluation described by Menakaya et al. Results: Thirty-three patients were included in the study. Correlation was found to be low between UBESS and RCOG (θ = 0.21) and between UBESS and CHI (θ = 0.30). The prediction of the operative plan was good for endometrioma, sites specific tenderness, sliding sign, vaginal and digestive tract involvement; but modest for the anterior compartment and uterosacrals ligaments. Conclusion: The UBESS score does not predict the surgical difficulty. The analysis with LOSSE (Level Of Skill in Surgery of Endometriosis), a new surgical classification, which we created specifically for endometriosis and more adapted to current surgical practices, confirmed our conclusions.
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Master Thesis
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Sarah Chaabane-Amharar. Endométriose : évaluation du score échographique UBESS (Ultrasound-Based Endometriosis Staging System) dans la prédiction de la difficulté chirurgicale. Médecine humaine et pathologie. 2018. ⟨dumas-02176380⟩

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