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.