1 Introduction
Abdominal wall endometriosis (AWE) refers to the presence of
endometrium-like tissue within the abdominal wall and is the most common
type of extrapelvic endometriosis in women of reproductive age [1].
The estimated prevalence of AWE is 0.03%-1% [2]. Typical
presentations of AWE are periodic progressively worsening pain and a
gradually enlarging palpable mass within the abdominal wall. These
symptoms affect the physical, mental and social well-being of patients
[3].
Surgical excision of the AWE mass is considered the first-line treatment
for AWE [4]. Previous studies have reported a success rate of
> 95% and a recurrence rate of < 5% with wide
local surgical excision of the AWE mass [5]; nevertheless, wide
local surgical excision may potentially lead to muscle and fascia
defects, which increase the risk of postoperative complications, such as
poor wound healing and hernia[5,6]. High-intensity focused
ultrasound (HIFU) ablation, which is a noninvasive approach widely used
to treat uterine myoma, adenomyosis, and placenta accreta, has been
applied in the treatment of AWE in the past decade. The results of
several studies suggest that HIFU ablation is an effective and safe
treatment for AWE, with low complication and recurrence rates [7-9].
However, studies comparing the effectiveness of surgery versus HIFU
ablation in the treatment of AWE have yielded controversial results
[10-14].
The aim of our study was to compare the efficiency and safety of surgery
versus HIFU ablation in the treatment of AWE.