Corresponding author at: Department of Surgery, “Metaxa” Memorial Cancer Hospital, Mpotasi 51, 18573 Piraeus, Greece.
was read the article
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"documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Ann Hepatol. 2020;19:5-16" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 207 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 131 "PDF" => 61 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Concise reviews</span>" "titulo" => "Multiple therapeutic targets in rare cholestatic liver diseases: Time to redefine treatment strategies" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "5" "paginaFinal" => "16" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1219 "Ancho" => 2167 "Tamanyo" => 197195 ] ] "descripcion" => array:1 [ "en" => "<p id="spar4035" class="elsevierStyleSimplePara elsevierViewall">Novel drugs for Primary Sclerosing Cholangitis (PSC). norUDCA, 24-norursodeoxicholic acid; FXR, farnesoid X receptor; FGF19, fibroblast growth factor 19; PPAR, peroxisome proliferator-activated receptor; VAP-1, vascular adhesion protein 1.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alessio Gerussi, Daphne D’Amato, Laura Cristoferi, Sarah Elizabeth O’Donnell, Marco Carbone, Pietro Invernizzi" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Alessio" "apellidos" => "Gerussi" ] 1 => array:2 [ "nombre" => "Daphne" "apellidos" => "D’Amato" ] 2 => array:2 [ "nombre" => "Laura" "apellidos" => "Cristoferi" ] 3 => array:2 [ "nombre" => "Sarah Elizabeth" "apellidos" => "O’Donnell" ] 4 => array:2 [ "nombre" => "Marco" "apellidos" => "Carbone" ] 5 => array:2 [ "nombre" => "Pietro" "apellidos" => "Invernizzi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119322604?idApp=UINPBA00004N" "url" => "/16652681/0000001900000001/v2_202001221934/S1665268119322604/v2_202001221934/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Concise reviews</span>" "titulo" => "Diagnosis, surgical treatment and postoperative outcomes of hepatic endometriosis: A systematic review" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "17" "paginaFinal" => "23" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Anastasia Prodromidou, Nikolaos Machairas, Anna Paspala, Natasha Hasemaki, Georgios C. Sotiropoulos" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Anastasia" "apellidos" => "Prodromidou" "email" => array:1 [ 0 => "a.prodromidou@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Nikolaos" "apellidos" => "Machairas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Anna" "apellidos" => "Paspala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Natasha" "apellidos" => "Hasemaki" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Georgios C." "apellidos" => "Sotiropoulos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Surgery, Division of Surgical Oncology, “Metaxa” Memorial Cancer Hospital, Piraeus, Greece" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Third Department of Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "First Department of Propaedeutic Surgery, “Laiko” General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Second Department of Propaedeutic Surgery, “Laiko” General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Department of Surgery, “Metaxa” Memorial Cancer Hospital, Mpotasi 51, 18573 Piraeus, Greece." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2336 "Ancho" => 2337 "Tamanyo" => 248399 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Search flow diagram.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">1</span><span class="elsevierStyleSectionTitle" id="sect2015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Endometriosis is a chronic estrogen dependent disorder characterized by the presence of endometrial-like tissue and stroma in extra-uterine locations. It most frequently is encountered in women of reproductive age (6–10%) while approximately 2.5% of postmenopausal women are diagnosed with the disease <a class="elsevierStyleCrossRefs" href="#bib0290">[1,2]</a>. The clinical symptoms that have been associated with endometriosis include chronic pelvic pain (71–87%), infertility (21–47%), dyspareunia, dysmenorrhea and bowel symptoms (constipation, dyschezia and diarrhea) <a class="elsevierStyleCrossRef" href="#bib0300">[3]</a>. However, no symptoms are reported in a considerable proportion of patients. Despite being considered as a benign entity, symptomatic endometriosis has been associated with significant morbidity and poor quality of life.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The most common locations of endometriosis include the ovaries, the uterine ligaments, the fallopian tubes and the pelvic peritoneum <a class="elsevierStyleCrossRef" href="#bib0305">[4]</a>. Extrapelvic endometrial tissue deposits have been described in many areas of female human body, whereas structures that are close to the uterus, such as the small and large bowel, female genitourinary system, and thorax, are more frequently affected than other distant locations <a class="elsevierStyleCrossRef" href="#bib0310">[5]</a>. Other rare locations of extrapelvic endometriosis include operative skin scars, the kidneys and the central nervous system <a class="elsevierStyleCrossRefs" href="#bib0315">[6–8]</a>. Hepatic endometriosis (HE) is one of the rarest forms of extrapelvic endometriosis and was first reported by Finkel et al. in 1986 <a class="elsevierStyleCrossRef" href="#bib0330">[9]</a>. Several case reports of HE have been published thereafter describing surgical treatment and clinicopathological characteristics of these lesions. Atypical clinical and radiological findings make diagnosis of HE challenging whilst confirmation of diagnosis can only be obtained by preoperative biopsy or via surgical resection.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of the present systematic review was to summarize the existing evidence on HE with special consideration to the natural history, the diagnosis and the surgical treatment of the disease.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2</span><span class="elsevierStyleSectionTitle" id="sect6020">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2.1</span><span class="elsevierStyleSectionTitle" id="sect8025">Study design</span><p id="par0020" class="elsevierStylePara elsevierViewall">All appropriate observational studies and case reports addressing cases of women who were diagnosed with hepatic endometrial cyst (pre- or intraoperatively) were considered eligible for inclusion in the present systematic review. Reviews and animal studies were excluded from analysis and tabulation. Only studies in English language were included. Patients who received conservative treatment for HE other than surgery were excluded. APas and APr independently and meticulously searched the literature, excluded overlaps, and tabulated the selected indices in structured forms.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2.2</span><span class="elsevierStyleSectionTitle" id="sect0030">Search strategy and data collection</span><p id="par0025" class="elsevierStylePara elsevierViewall">We systematically searched the literature for articles published up to March 2019 using PubMed (1966–2019), Scopus (2004–2019), and Google Scholar (2004–2019) databases along with the references of the articles which were retrieved in full text. The following key words were used for the search: “endometriosis”, “liver endometriosis”, “hepatic endometriosis”, “endometrial liver cyst”, “endometrial hepatic cyst”, “extrapelvic endometriosis”, “distant endometriosis”. A minimum number of search keywords were utilized in an attempt to assess an eligible number that could be easily searched while simultaneously minimizing the potential loss of articles. Articles that fulfilled or were deemed to fulfill the inclusion criteria were retrieved; all articles which described cases of women aged >18 years who were surgically managed for liver lesions diagnosed pre- or postoperatively as endometriosis were included. Studies including cases of women who did not underwent surgery for the treatment of the hepatic lesion were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram schematically presents the stages of article selection (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Our search strategy included the MeSH terms:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0035" class="elsevierStylePara elsevierViewall">(“liver”[MeSH Terms] OR “liver”[All Fields]) AND (“endometriosis”[MeSH Terms] OR “endometriosis”[All Fields])</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0040" class="elsevierStylePara elsevierViewall">hepatic[All Fields] AND (“endometriosis”[MeSH Terms] OR “endometriosis”[All Fields])</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0045" class="elsevierStylePara elsevierViewall">endometrial[All Fields] AND (“liver”[MeSH Terms] OR “liver”[All Fields]) AND (“cysts”[MeSH Terms] OR “cysts”[All Fields] OR “cyst”[All Fields])</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0050" class="elsevierStylePara elsevierViewall">endometrial[All Fields] AND hepatic[All Fields] AND (“cysts”[MeSH Terms] OR “cysts”[All Fields] OR “cyst”[All Fields])</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">•</span><p id="par0055" class="elsevierStylePara elsevierViewall">extrapelvic[All Fields] AND (“endometriosis”[MeSH Terms] OR “endometriosis”[All Fields])</p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall">Data on patient characteristics included age, parity, menopausal status, abnormal liver function parameters, prior endometriosis and surgical history, primary signs and symptoms and outcomes of clinical examination and imaging of the recruited patients. Concerning the main findings of the study, indication for surgery and type of surgery were appraised. Moreover, intraoperative and postoperative outcomes were as well evaluated and encompassed length of hospital stay, complications and histopathological outcomes of the excised specimens, if available.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2.3</span><span class="elsevierStyleSectionTitle" id="sect0035">Definitions</span><p id="par0065" class="elsevierStylePara elsevierViewall">Minor liver resection is defined as resection of less than 3 liver segments while major liver resection is defined as resections of at least 3 liver segments <a class="elsevierStyleCrossRef" href="#bib0335">[10]</a>. Cyst resection is defined as the non-anatomic resection of liver parenchyma surrounding the endometriotic cystic lesion.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2.4</span><span class="elsevierStyleSectionTitle" id="sect0040">Quality assessment</span><p id="par0070" class="elsevierStylePara elsevierViewall">Case reports and case series are related to elevated bias due to the nature of those types of studies <a class="elsevierStyleCrossRef" href="#bib0340">[11]</a>. Nonetheless, in case when data on a certain condition is limited evidence from those studies is considered of clinical importance. We evaluated the quality of the enrolled studies by adopting a quality assessment tool for case reports and case series proposed by Murad et al. More specifically, the methodological quality of the studies was assessed based on the criteria including the domains of ascertainment, causality, selection and reporting. The sum of the scores derived from eight critical questions referred to the domains was used to evaluate the quality of each study as well as the reviewer's judgement on the presence of the most important domains according to certain clinical case.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3</span><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3.1</span><span class="elsevierStyleSectionTitle" id="sect0050">Excluded studies</span><p id="par0075" class="elsevierStylePara elsevierViewall">A total of 11 were excluded from the present review. Among them, 4 were excluded due to insufficient data <a class="elsevierStyleCrossRefs" href="#bib0345">[12–15]</a>. Additionally, in 4 cases the patients received conservative HE treatment with pharmaceutical and thus they were not included <a class="elsevierStyleCrossRefs" href="#bib0365">[16–19]</a>. The study by Finkel et al. was excluded as it was a part of an already included study <a class="elsevierStyleCrossRef" href="#bib0330">[9]</a>. Two studies described cases of HE with concomitant presence of adenosarcoma in the lesion <a class="elsevierStyleCrossRefs" href="#bib0385">[20,21]</a>.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3.2</span><span class="elsevierStyleSectionTitle" id="sect0055">Main characteristics of included studies</span><p id="par0080" class="elsevierStylePara elsevierViewall">A total of 27 studies (23 case reports and 4 case series) which comprised 32 patients who were diagnosed with a hepatic endometriotic lesion were included in the present systematic review <a class="elsevierStyleCrossRefs" href="#bib0395">[22–48]</a>.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Based on the type of the included clinical cases we considered the score of 5 points as the highest that could be assessed when excluding the three questions from the quality assessment tool that attributed to cases of adverse drug events. The scores of each study are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A mean score of 3.7 (SD<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.98) was calculated whereas the overall judgement on the quality of the recruited studies was that they were of moderate quality.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> depicts the main characteristics of the included patients. The mean age of the included patients was 39.7 years (SD<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.95 years) while parity status was available for 16 (50%) patients. Among them, 10 (62.5%) were nulliparous whereas the remaining 6 (37.5%) have given birth to one or more children. Despite the fact that 24 (75%) women were of reproductive age (18–45 years), the proportion of premenopausal women was 19 (59.4%) while the remaining 13 (40.6%) were postmenopausal. A total of 12 (37.5%) women with age range from 31 to 56 had undergone bilateral salpingoophorectomy with hysterectomy (BSO-HY) or without and were considered surgical menopausal. Among them, 6 of them had undergone the aforementioned procedures due to endometriosis. Hormone replacement therapy (HRT) was administered in 4 of them and in one who underwent no endometriosis related BSO-HY. Eleven out of 30 patients (36.7%) had a history of pelvic endometriosis of various sites such as ovarian, fallopian, cervical, peritoneal, pouch of Douglas or colonic endometriosis. Sixteen out of 32 patients (50%) had a history of prior gynecologic or obstetric surgery for various indications which included cesarean section, endometriosis related hysterectomy, oophorectomy for teratoma, hysterectomy for uterine leiomyoma, endometrioma and pelvic endometriosis excision.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3.3</span><span class="elsevierStyleSectionTitle" id="sect0060">Disease-related characteristics</span><p id="par0095" class="elsevierStylePara elsevierViewall">Abdominal pain (AP) was the primary symptom in 28 patients (87.5%) whereas 4 (12.1%) were asymptomatic and were incidentally diagnosed with a liver mass. Among patients with AP, 13 (44.8%) women described right upper guardant (RUQ) AP, 7 (21.9%) complained for epigastric pain (EP), one (3.4%) had left AP whereas had diffuse AP. Abdominal pain was cyclic-menstruation related in 3 cases. Nausea and vomiting was described by 4 (12.5%) women. Clinical examination revealed a palpable mass in 7 women. In one patient ascites and mild jaundice were detected <a class="elsevierStyleCrossRef" href="#bib0495">[42]</a>. Imaging outcomes were reported for all except two women, included Ultrasound (US), Computed Tomography (CT), Magnetic resonance imaging (MRI) or a combination of them and are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Abnormal liver function was present in 3 out of 24 (12.5%) patients. Preoperative diagnosis of endometriosis through either biopsy, imaging or patients’ history was available for 5 patients. Six patients underwent a preoperative diagnostic procedure (biopsy or fine needle aspiration – FNA). In 2 of them a preoperative percutaneous biopsy of the mass revealed endometrial tissue <a class="elsevierStyleCrossRefs" href="#bib0405">[24,42]</a>. In the remaining cases, atypical findings such as necrotic and inflammatory tissue, hemangioma and epithelial cells suspicious of malignancy were detected.</p><p id="par0100" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, indication for surgery was available for 26 cases. Among them, 5 cases underwent surgery due to endometriosis either recurrent (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) or primary (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4) which was preoperatively diagnosed. In 11 cases a misdiagnosis led to surgery. More specifically, differential diagnosis in these patients included malignancy or other lesions such as liver cystadenoma or hematoma. Eight patients were led to surgery due to symptomatic disease; two for biliary obstruction and 6 due to abdominal pain and/or vomiting. Finally, diagnostic purpose was the main indication of surgery in 2 cases.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3.4</span><span class="elsevierStyleSectionTitle" id="sect0065">Operative outcomes</span><p id="par0105" class="elsevierStylePara elsevierViewall">All patients underwent surgery for the treatment of their liver mass. Data with regard to the type of surgery was available for 31 patients. Among them, 14 (45.2%) underwent cyst resection while the remaining 17 had more extended liver resections which included minor or major hepatectomies (9/31 and 8/31, respectively). Intraoperatively, gross examination of the affected liver revealed cystic lesions filled with fluid which ranged in color from clear to chocolate colored. Intraoperative diagnosis of endometriosis with frozen section histology was made for 5 cases. Furthermore, in 8 women, an additional procedure for the excision of lesions in the surrounding structures or in the pelvic was performed as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Four (12.5%) patients underwent laparoscopic surgical procedures whereas the remaining 28 (87.5%) underwent open surgery. Histological examination confirmed the diagnosis of endometriosis and revealed the characteristic endometriotic features which included the presence of endometrial stroma and glands. In cases in which immunochemistry was performed ER and PR positivity was recognized as well as CK7 positive staining in the examined specimens. The length of hospital stay ranged from 1 to 13 days, based on the type and the approach of the procedures. No postoperative complications were reported except one case bile leak <a class="elsevierStyleCrossRef" href="#bib0495">[42]</a>. The same patient was readmitted 18 months postoperatively when two liver masses in the left lobe were found and aspired with complete remission of the symptoms and no complication reported for the following 4 years. Finally, one patient in the study by Hsu et al. showed pelvic endometriosis recurrence within 18 years postoperatively <a class="elsevierStyleCrossRef" href="#bib0425">[28]</a>. No postoperative deaths were reported from the included studies.</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">4</span><span class="elsevierStyleSectionTitle" id="sect0070">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Extrapelvic endometriosis is defined as the presence of ectopic endometrial tissue in structures outside the pelvis such as the lungs, the brain, the urinary system and the gastrointestinal tract. Presence of endometriosis in extrapelvic sites is uncommon with a prevalence that is not easily estimated due to lack of population based epidemiological trials <a class="elsevierStyleCrossRef" href="#bib0315">[6]</a>. Additionally, the pathogenesis of extrapelvic endometriosis still remains ill-determined; a plethora of theories have been proposed concerning the pathogenetic pathway of extrapelvic endometriosis. Among them, metaplasia of the peritoneum due to chronic inflammation and implantation of endometrial tissue in extrapelvic sites through fallopian tubes during retrograde menstruation are the most prevalent <a class="elsevierStyleCrossRef" href="#bib0530">[49]</a>. Furthermore, a mechanism of lymphatic or haematogenous spread in distant structures similar to this of metastatic malignancies has also been advocated <a class="elsevierStyleCrossRefs" href="#bib0315">[6,50]</a>. The present study indicates that approximately half of the included patients had a history of previous gynaecologic surgery and thus one can hypothesize that a previous gynaecologic surgery could play a role in dissemination of endometrial cells in the peritoneal cavity.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Preoperative diagnosis of HE can be challenging due to atypical clinical findings and radiological features; a limited number of the examined cases in the present study reported a clear preoperative endometriosis diagnosis even in cases in which a preoperative diagnostic procedure was performed. Additionally, the diagnosis was even more challenging to establish due to the lack of previous history of pelvic endometriosis in more than half of the included women or the manifestation of non-specific endometriosis-related symptoms in a significant proportion of the included patients. In that setting, despite the fact that almost in all the included cases the primary symptom was AP, association of pain with menses (cyclical onset of symptoms and pain) was only reported in 2 cases. To that end, the specific symptoms that can be attributed to HE still remain ill-determined. Additionally, despite the fact that almost all the included patients preoperatively underwent more than one diagnostic imaging procedure including US, CT and MRI along, which mainly described a hepatic cystic lesion without special characteristics with biopsy in some cases, preoperative recognition of the liver mass as endometriotic was only successful in only 5 patients (16%). The differential diagnosis in most cases included hematoma, haemangioma, abscess, metastasis or echinococcal cyst, even in cases of a past endometriosis history. Notably, 4 cases had preoperative radiological features which demonstrated a malignant condition <a class="elsevierStyleCrossRefs" href="#bib0435">[30,32,33,41]</a>.</p><p id="par0120" class="elsevierStylePara elsevierViewall">On the other hand, malignant transformation of endometriosis is relatively rare and accounts for less than 1% of cases with the vast majority of them arising in the ovary <a class="elsevierStyleCrossRef" href="#bib0390">[21]</a>. Accordingly, with regard to malignancy arising from hepatic endometriosis data is extremely scarce. To that end, 2 cases of adenosarcoma arising from hepatic endometriosis have been identified in a 52- and 54-year-old women who both underwent resection with no evidence of recurrence during the follow-up period <a class="elsevierStyleCrossRefs" href="#bib0385">[20,21]</a>.</p><p id="par0125" class="elsevierStylePara elsevierViewall">One could argue that endometriosis as a hormone-dependent disease mostly affects women of reproductive age <a class="elsevierStyleCrossRef" href="#bib0540">[51]</a>. The current literature estimates an incidence of endometriosis in menopause which ranges from 2% to 5% <a class="elsevierStyleCrossRef" href="#bib0545">[52]</a>. The exact pathogenetic pathway still remains elusive; one theory on that suggests that postmenopausal endometriosis is due to the presence and activation of endometrial implants especially in women who received exogenous hormone replacement therapy and have a previous history of endometriosis <a class="elsevierStyleCrossRef" href="#bib0545">[52]</a>. Additionally, some cases of de novo postmenopausal endometriosis in patients without history of endometriosis have been recorded but whether those cases are de novo or previous asymptomatic undiagnosed endometriosis is still under consideration <a class="elsevierStyleCrossRef" href="#bib0550">[53]</a>. According to the findings of the present study, a significant proportion of patients (approximately 40%) were postmenopausal. Four of them, were diagnosed with HE but reported no previous history of the disease. Menopause was surgically induced in 12 patients while 5 received hormone replacement therapy. This finding is in accordance with previous reports concerning the detection of extrapelvic endometriosis in older age compared to the pelvic form of the disease <a class="elsevierStyleCrossRefs" href="#bib0315">[6,54]</a>.</p><p id="par0130" class="elsevierStylePara elsevierViewall">The vast majority of the included patients underwent open procedures, which ranged from simple cyst resection to major liver resection based on the location and size of the endometriotic lesions within the liver. However, there were also 4 patients who underwent cyst resection through a laparoscopic approach, indicating that it may be an efficient minimally invasive approach in selected cases. It should be also reminded that both minor and major laparoscopic liver resections for both benign and malignant hepatic lesions are currently acknowledged as standard procedures with improved short- and adequate long-term outcomes <a class="elsevierStyleCrossRefs" href="#bib0560">[55–57]</a>. Regardless of the type of approach, cumulative morbidity and mortality rates were 3% and 0%, respectively, whereas recurrence was noted only in 1 patient. To that end, it is evident that liver resections for the treatment of HE are safe and efficient procedures when performed by surgeons with experience in the field.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The present review is to the best of our knowledge, the only review in literature, which presents a cumulative report of the natural history, characteristics and management of adult females with HE. A thorough search of the literature along with the fact that no date restrictions were imposed, eliminated the risk of potential loss of articles. The true prevalence of HE could not be precisely reached and data concerning its pathophysiology, clinical appearance and treatment is limited to case reports and small case series precluded further research due to its rare entity. Furthermore, the significant heterogeneity of the included studies along with the fact that some parameters were omitted by some studies was another limitation and precluded reaching to firm results.</p><p id="par0140" class="elsevierStylePara elsevierViewall">In conclusion, preoperative diagnosis of HE can be challenging due to variable radiologic features and clinical symptomatology. Nonetheless, it should be considered in the differential diagnosis of a liver mass especially in premenopausal women with a history of endometriosis of other sites. The type of resection of the endometriotic lesion is based on the extent and the location of the disease and presented with favorable outcomes with regard to morbidity, mortality, symptom relief and recurrence.<span class="elsevierStyleDefList"><span class="elsevierStyleSectionTitle" id="sect0075">Abbreviations</span><span class="elsevierStyleDefTerm">HE</span><span class="elsevierStyleDefDescription"><p id="par0145" class="elsevierStylePara elsevierViewall">hepatic endometriosis</p></span><span class="elsevierStyleDefTerm">AP</span><span class="elsevierStyleDefDescription"><p id="par0150" class="elsevierStylePara elsevierViewall">abdominal pain</p></span><span class="elsevierStyleDefTerm">BSO-HY</span><span class="elsevierStyleDefDescription"><p id="par0155" class="elsevierStylePara elsevierViewall">bilateral salpingoophorectomy with hysterectomy</p></span><span class="elsevierStyleDefTerm">HRT</span><span class="elsevierStyleDefDescription"><p id="par0160" class="elsevierStylePara elsevierViewall">hormone replacement therapy</p></span><span class="elsevierStyleDefTerm">RUQ</span><span class="elsevierStyleDefDescription"><p id="par0165" class="elsevierStylePara elsevierViewall">right upper guardant</p></span><span class="elsevierStyleDefTerm">EP</span><span class="elsevierStyleDefDescription"><p id="par0170" class="elsevierStylePara elsevierViewall">epigastric pain</p></span></span></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Funding</span><p id="par0175" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1289621" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1191503" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Search strategy and data collection" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Definitions" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Quality assessment" ] ] ] 4 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Excluded studies" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Main characteristics of included studies" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Disease-related characteristics" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "Operative outcomes" ] ] ] 5 => array:2 [ "identificador" => "sec0060" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0065" "titulo" => "Funding" ] 7 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-04-20" "fechaAceptado" => "2019-08-09" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1191503" "palabras" => array:5 [ 0 => "Hepatic endometriosis" 1 => "Liver endometriosis" 2 => "Endometriosis" 3 => "Liver" 4 => "Cyst" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endometriosis is characterized by the presence of endometrial-like tissue and stroma in extra-uterine locations. Hepatic endometriosis (HE) is one of the rarest forms of extrapelvic endometriosis. We aimed to summarize the existing evidence on HE with special consideration to natural history, diagnosis and surgical treatment.</p><p id="spar7010" class="elsevierStyleSimplePara elsevierViewall">Three electronic databases were systematically searched for articles published up to March 2019. All appropriate observational studies and case reports addressing cases of women with HE were considered eligible for inclusion.</p><p id="spar5015" class="elsevierStyleSimplePara elsevierViewall">A total of 27 studies which comprised 32 patients with HE were included. Mean age of patients was 39.7 years. Ten (62.5%) were nulliparous and 24 (75%) were women of reproductive age. Eleven patients (36.7%) had a history of pelvic endometriosis of various sites. Abdominal pain was the primary symptom in 28 patients (87.5%). Preoperative diagnosis of endometriosis was available for 5 patients and 6 underwent a preoperative diagnostic procedure. Cyst resection, minor and major liver resections were performed in 14/31, 9/31 and 8/31 patients, respectively.</p><p id="spar1020" class="elsevierStyleSimplePara elsevierViewall">Preoperative diagnosis of HE is challenging due to variable radiologic features and clinical symptomatology. Nonetheless, it should be considered in the differential diagnosis of a liver mass especially in premenopausal women with a history of endometriosis. The type of resection of the endometriotic lesion is based on the extent and the location of the disease and presented with favourable outcomes concerning morbidity, symptom relief and recurrence.</p></span>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2336 "Ancho" => 2337 "Tamanyo" => 248399 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Search flow diagram.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">QAS: quality assessment score, AP: abdominal pain, AT: abdominal tenderness, PP: pelvic pain, EAP: epigastric abdominal pain, RUQ: right upper quadrant, LUQ: left upper quadrant, LLQ: left low quadrant, BSO-HY: bilateral salpingo-oophorectomy plus hysterectomy, HE: hepatic endometriosis, IO: intraoperative, HY: hysterectomy.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Year; author \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">QAS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary symptom/physical examination \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Preoperative diagnosis/lesion size/location \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Menopausal status/HRT/endometriosis related \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Indication for surgery \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of surgical procedure \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2018; Keramidaris \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asymptomatic/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and MRI/10.3<span class="elsevierStyleHsp" style=""></span>cm/segments IV, II and III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laparoscopic cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2016; Riggi \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Constant LUQ and LLQ AT/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, CT and MRI/30<span class="elsevierStyleHsp" style=""></span>cm/segments IV, V and VII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosed HE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Atypical left hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2016; Sherif \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyclical RUQ AP and vomiting/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, MRI and CT/3<span class="elsevierStyleHsp" style=""></span>cm/segment VII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre HY for endometriosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Segmentectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2015; Liu \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/6<span class="elsevierStyleHsp" style=""></span>cm/segment III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2014; Sopha \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP, vomiting and diarrhea/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/1.3<span class="elsevierStyleHsp" style=""></span>cm/segment VII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY no endometriosis related/HRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laparoscopic wedge resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2014; Zhao \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asymptomatic/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/6<span class="elsevierStyleHsp" style=""></span>cm/segment IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosed HE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2014; Hsu</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP and infertility/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/2<span class="elsevierStyleHsp" style=""></span>cm/segment VIII and hemoperitoneum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proctectomy and partial hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asymptomatic/palpable mass in LUQ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/17<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO endometriosis related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Partial hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intermittent EAP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extended left hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP after reintroduction of hormone replacement therapy/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRI/6.5<span class="elsevierStyleHsp" style=""></span>cm/segment VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wedge resection and peritoneal lesions resection omentum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013; Hertel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Severe sudden onset upper AP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRI/11.2<span class="elsevierStyleHsp" style=""></span>cm/right lobe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY no endometriosis related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute AP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Partial hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013; Bouras \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EP/palpable tender epigastric mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT and MRI/10<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> involved right ventricle and diaphragm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left lateral sectionectomy, partial right ventricle free wall resection and medial diaphragm resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013; Fluegen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-cyclic RUQ, central recurrent liver cyst; AT/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRI/12<span class="elsevierStyleHsp" style=""></span>cm/segments IV, V and VIII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biliary obstruction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012; Rivkine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EAP and vomiting/EAP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, CT and MRI/8<span class="elsevierStyleHsp" style=""></span>cm/segments II and III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre-HY no endometriosis related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left hepatectomy and diaphragm resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009; Goldsmith \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/RUQ AT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and MIRI/11<span class="elsevierStyleHsp" style=""></span>cm/segments IV and VIII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY endometriosis related HRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nonanatomical resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007; Lolis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/palpable mass in RUQ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/8<span class="elsevierStyleHsp" style=""></span>cm/segment VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnostic purpose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2005; Nezhat</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyclic EAP/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/3<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosed HE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laparoscopic cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic PP, dysmenorrhea and painful bowel movements/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, MRI: no pathologic finding \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnostic purpose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laparoscopic cyst resection, resection of diaphragmatic and pelvic implants \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2005; Girlanda \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, CT and MRI/7 and 6.5<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-endometriosis related HRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection, omentum and peritoneum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2004; Carbone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper AP/right hypochondrial rounded tender mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/13<span class="elsevierStyleHsp" style=""></span>cm/segments II, III and IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Misdiagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2003; Reid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/11<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY endometriosis related HRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recurrent HE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right hemihepatectomy, cholecystectomy and diaphragmatic resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2003; Tuech \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic acyclic EAP/RUQ AT and palpable mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/24<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosed HE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2003; Groves \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, CT and MRI/multiple lesions, largest 12<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right hemihepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2002; Huang \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, MRI and CT/9<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY endometriosis related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extended left hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2002; Khan \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP, malaise/ascites, mild jaundice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Angiography – portal vein thrombosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY endometriosis related HRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biliary obstruction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">En bloc resection of mass in the right lobe (cyst resection) left lobe intrahepatic endometrial tissue had no capsule and was left in situ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2001; Bohra \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vague AP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-BSO-HY \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1998; Chung \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incidental finding, No symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT/6.4<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of cystadenoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1996; Cravello \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyclic RUQ AP menstruation related, dysmenorrhea, infertility/no findings \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US, CT and MRI/6<span class="elsevierStyleHsp" style=""></span>cm/segment VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wedge resection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1996; Verbeke</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/5</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute AP/acute abdomen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRI and CT/12<span class="elsevierStyleHsp" style=""></span>cm/right lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hematoma liver \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right hepatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RUQ AP/N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/12<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection and cholecystectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1990; Rovati \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic acyclic EAP/epigastric palpable mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/10<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnostic purposes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left lateral segmenectomy2nd laparotomy for left adnexectomy was performed because of an ovarian endometrioma of 5<span class="elsevierStyleHsp" style=""></span>cm diameter. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1986; Grabb \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EAP, nausea, vomiting/RUQ tender mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">US and CT/13<span class="elsevierStyleHsp" style=""></span>cm/left lobe<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cyst resection \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2208702.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Not otherwise specified.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Main characteristics of the included patients.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:57 [ 0 => array:3 [ "identificador" => "bib0290" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical practice. Endometriosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.C. Giudice" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMcp1000274" "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2010" "volumen" => "362" "paginaInicial" => "2389" "paginaFinal" => "2398" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0295" "etiqueta" => "[2]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endometriosis: a premenopausal disease? Age pattern in 42,079 patients with endometriosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Haas" 1 => "R. Chvatal" 2 => "B. Reichert" 3 => "S. Renner" 4 => "O. Shebl" 5 => "H. 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Year/Month | Html | Total | |
---|---|---|---|
2024 November | 6 | 0 | 6 |
2024 October | 40 | 2 | 42 |
2024 September | 28 | 3 | 31 |
2024 August | 34 | 11 | 45 |
2024 July | 26 | 4 | 30 |
2024 June | 41 | 5 | 46 |
2024 May | 37 | 3 | 40 |
2024 April | 40 | 11 | 51 |
2024 March | 45 | 5 | 50 |
2024 February | 36 | 6 | 42 |
2024 January | 37 | 7 | 44 |
2023 December | 35 | 9 | 44 |
2023 November | 33 | 8 | 41 |
2023 October | 45 | 11 | 56 |
2023 September | 18 | 2 | 20 |
2023 August | 21 | 5 | 26 |
2023 July | 21 | 3 | 24 |
2023 June | 23 | 5 | 28 |
2023 May | 50 | 11 | 61 |
2023 April | 43 | 5 | 48 |
2023 March | 53 | 3 | 56 |
2023 February | 37 | 14 | 51 |
2023 January | 14 | 14 | 28 |
2022 December | 20 | 21 | 41 |
2022 November | 20 | 23 | 43 |
2022 October | 20 | 16 | 36 |
2022 September | 52 | 9 | 61 |
2022 August | 16 | 12 | 28 |
2022 July | 18 | 6 | 24 |
2022 June | 22 | 9 | 31 |
2022 May | 25 | 13 | 38 |
2022 April | 31 | 10 | 41 |
2022 March | 30 | 11 | 41 |
2022 February | 24 | 7 | 31 |
2022 January | 41 | 4 | 45 |
2021 December | 11 | 15 | 26 |
2021 November | 13 | 5 | 18 |
2021 October | 17 | 14 | 31 |
2021 September | 6 | 12 | 18 |
2021 August | 31 | 4 | 35 |
2021 July | 24 | 9 | 33 |
2021 June | 19 | 11 | 30 |
2021 May | 23 | 6 | 29 |
2021 April | 63 | 16 | 79 |
2021 March | 30 | 6 | 36 |
2021 February | 11 | 13 | 24 |
2021 January | 17 | 11 | 28 |
2020 December | 12 | 7 | 19 |
2020 November | 18 | 11 | 29 |
2020 October | 21 | 9 | 30 |
2020 September | 38 | 8 | 46 |
2020 August | 13 | 11 | 24 |
2020 July | 23 | 14 | 37 |
2020 June | 18 | 6 | 24 |
2020 May | 11 | 12 | 23 |
2020 April | 27 | 7 | 34 |
2020 March | 46 | 16 | 62 |
2020 February | 69 | 6 | 75 |
2020 January | 46 | 18 | 64 |
2019 December | 4 | 7 | 11 |
2019 November | 3 | 4 | 7 |
2019 October | 7 | 18 | 25 |