Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach

Welch, Brian T.; Ehman, Eric C.; VanBuren, Wendaline M.; Cope, Adela G.; Welch, Tasha L.; Woodrum, David A.; Kurup, A. Nick; Burnett, Tatnai L.

doi:10.1007/s00261-019-02379-4

Cited by 29 publications

(14 citation statements)

References 26 publications

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“…Radiologic-guided procedures are rapidly emerging as novel and effective noninvasive therapies for the treatment of AWE. Ultrasound-guided high intensity focused ultrasound (USgHIFU) ablation and percutaneous cryoablation have shown particular promise in retrospective studies [17 ▪ ,18 ▪▪ ,19 ▪ ,20]. USgHIFU uses targeted ultrasonic energy to instantaneously heat tissue, resulting in coagulative necrosis without damaging surrounding structures.…”

Section: Treatment Options and Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Abdominal wall endometriosis: an update in diagnosis, perioperative considerations and management

Allen

Rindos

Mansuria

2021

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review Abdominal wall endometriosis (AWE) is rare with limited evidence guiding diagnosis and treatment. The purpose of this review is to provide an update of the diagnosis, perioperative considerations, and treatment of AWE. Recent findings Recent studies further characterize presenting symptoms and locations of AWE. Prior abdominal surgery remains the greatest risk factor for the development of AWE. Newer evidence suggests that increasing BMI may also be a risk factor. Ultrasound is first-line imaging for diagnosis. Magnetic resonance image is preferred for surgical planning for deep or extensive lesions. Laparotomy with wide local excision is considered standard treatment for AWE with great success. Novel techniques in minimally invasive surgery have been described as effective for the treatment of AWE. A multidisciplinary surgical approach is often warranted for successful excision and reapproximation of skin and/or fascial defects. Noninvasive therapies including ultrasonic ablation or cryotherapy are also emerging as promising treatment strategies in select patients. Summary Recent studies provide further evidence to guide diagnosis through physical exam and imaging as well as pretreatment planning. Treatment options for AWE are rapidly expanding with novel approaches in minimally invasive and noninvasive therapies now available.

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Section: Treatment Options and Outcomesmentioning

confidence: 99%

“…Percutaneous cryoablation for treatment of AWE has been described in detail by Welch et al from the Mayo Clinic [19 ▪ ]. This technique has been successfully used to treat abdominal wall tumors and has recently been applied to the treatment of AWE.…”

Section: Treatment Options and Outcomesmentioning

confidence: 99%

Abdominal wall endometriosis: an update in diagnosis, perioperative considerations and management

Allen

Rindos

Mansuria

2021

Current Opinion in Obstetrics &Amp; Gynecology

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“…However, in most cases, scars even block acoustic beams from entering the body, causing residual lesions in the abdominal wall. Percutaneous image-guided cryoablation is performed under general anesthesia, and non-contrast CT or MRI monitoring of the growth and position of the ice ball is performed at 2–4 min intervals during the freeze–passive thaw–freeze cycle ( 15 ). Its benefits include intraprocedural ice ball visualization, which increases safety and mitigates the risk of injury to adjacent soft tissue collagenous architecture structures ( 14 , 41 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

“…There are some disadvantages to HIFU ablation, including nonpathological results and residual lesions in the abdominal wall ( 13 ). Percutaneous image-guided cryoablation is performed under general anesthesia and may cause additional complications ( 14 , 15 ). Ultrasound-guided microwave ablation is characterized by high ablation temperatures, large ablation volumes, fast ablation times, and the ability to use multiple applicators simultaneously and can be proposed in outpatients ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of microwave ablation for abdominal wall endometriosis: A retrospective study

et al. 2023

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ObjectivesThis retrospective study aimed to evaluate the safety and feasibility of ultrasound-guided microwave ablation in the treatment of abdominal wall endometriosis (AWE).BackgroundAWE is a rare form of endometriosis that often results in cyclic abdominal pain. The current treatment algorithm for AWE is not well established. Microwave ablation technology is a promising new thermal ablation technique for treating AWE.MethodsThis was a retrospective study of nine women with pathologically proven endometriosis of the abdominal wall. All patients were treated with ultrasound-guided microwave ablation. Grey-scale and color Doppler flow ultrasonography, contrast-enhanced ultrasonography, and MRI were used to observe the lesions before and after treatment. The complications, pain relief, AWE lesion volume, and volume reduction rate were recorded 12 months after treatment to evaluate the treatment efficacy. Complications were classified according to the Common Terminology Criteria for Adverse Events and the Society of Interventional Radiology classification system.ResultsContrast-enhanced ultrasound showed that all lesions underwent successful treatment with microwave ablation. The average initial nodule volume was 7.11 ± 5.75 cm3, which decreased significantly to 1.85 ± 1.02 cm3 at the 12-month follow-up with a mean volume reduction rate of 68.77 ± 12.50%. Periodic abdominal incision pain disappeared at 1 month after treatment in all nine patients. The adverse events and complications were Common Terminology Criteria for Adverse Events grade 1 or Society of Interventional Radiology classification grade A.ConclusionsUltrasound-guided microwave ablation is a safe and effective technique for the treatment of AWE, and further study is warranted.

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“…Previously reported surgical approaches to AWE include ablative techniques like percutaneous cryoablation or ethanol injection. 6 If abdominal wall endometriosis involves the fascia, surgical excision can still be performed via minimally invasive approach with endoscopic mesh placement and fascial repair by General surgery. Intraoperative techniques to assist with excision include injecting the lesion with methylene blue or ultrasoundguided wire localization.…”

mentioning

confidence: 99%

Ultrasound-guided Spinal Needle Localization for Resection of Abdominal Wall Endometrioma

Misal¹,

Young²,

Chiang

et al. 2021

Journal of Minimally Invasive Gynecology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach

Cited by 29 publications

References 26 publications

Abdominal wall endometriosis: an update in diagnosis, perioperative considerations and management

Abdominal wall endometriosis: an update in diagnosis, perioperative considerations and management

Safety and efficacy of microwave ablation for abdominal wall endometriosis: A retrospective study

Ultrasound-guided Spinal Needle Localization for Resection of Abdominal Wall Endometrioma

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