Enzian classification in preoperative ultrasound examination and intraoperative staging of endometriosis

Objective. To compare the size and localization of endometrioid foci, to compare the severity of the adhesive process in the small pelvis, assessed using preoperative ultrasound and intraoperative staging according to the Enzian classification. Materials and methods. A retrospective analysis of the data of 106 patients who underwent surgery in a specialized center for infiltrative endometriosis was performed. Results. The informative value of ultrasound in detecting rectal infiltrates (Enzian C) showed the highest level of compliance with intraoperative diagnosis in 94.3% of cases. For division B (uterosacral ligaments, parametrium) and division A (vagina, rectovaginal ligament), concordance rates were slightly lower — 79.2% and 88.7%, respectively. In department O (ovaries), high accurate rates of coincidence with the results of intraoperative staging were observed, similar to those established for Compartment C. The diagnosis of the lesion of the T division (tubular complex) was the most difficult. The largest number of observations of the correct diagnosis of adhesions of the ovarian tissue, fallopian tube and underlying structures was revealed in severe adhesions (T3). Conclusion. The preoperative assessment of the localization and size of endometrioid foci using ultrasound in various departments according to the Enzian classification is highly accurate and provides a detailed preoperative description of the prevalence of endometriosis.