Surgical treatment of deeply infiltrating endometriosis with colorectal involvement
Christel Meuleman,Carla Tomassetti,André D'Hoore,Ben Van Cleynenbreugel,Freddy Penninckx,Ignace Vergote,Thomas D'Hooghe +6 more
TLDR
Prospective studies reporting standardized and well-defined clinical outcome after surgical treatment of deeply infiltrating endometriosis with colorectal involvement with long-term follow-up are needed.Abstract:
background: Treatment of colorectal endometriosis is difficult and challenging. We reviewed the clinical outcome of surgical treatment of deeply infiltrating endometriosis (DIE) with colorectal involvement. methods: Review was based upon a literature search using following search terms: (1) ‘surgery’ and ‘colorectal endometriosis’, (2) ‘bowel’ and ‘endometriosis’ and ‘surgery’. Inclusion criteria: clear explanation of surgical technique and follow-up data on at least one of the following items: complications, pain, quality of life (QOL), fertility and recurrence. results: Most of the 49 studies included complications (94%) and pain (67%); few studies reported recurrence (41%), fertility (37%) and QOL (10%); only 29% reported (loss of) follow-up. Out of 3894 patients, 71% received bowel resection anastomosis, 10% received fullthickness disc excision and 17% were treated with superficial surgery. Comparison of clinical outcome between different surgical techniques was not possible. Post-operative complications were present in 0 –3% of the patients. Although pain improvement was reported in most studies, pain evaluation was patient-based in ,50% (Visual Analogue Scale in only 18%). While QOL was improved in most studies, prospective data were only available for 149 patients. Pregnancy rates were 23–57% with a cumulative pregnancy rate of 58 –70% within 4 years. The overall endometriosis recurrence rate in studies (.2 years follow-up) was 5 –25% with most of the studies reporting 10%. Owing to highly variable study design and data collection, a CONSORT-inspired checklist was developed for future studies.read more
Citations
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Medrobotics Flex transanal excision of a rectal gastrointestinal stromal tumour: first video of the transanal Flex robot used in a human – a video vignette
TL;DR: This is the first video of the new transanal Flex Robotic System in a human, which takes a non-linear path to the target lesion, throughout which it is able to deploy compatible flex instruments to facilitate dissection.
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Why we need international agreement on terms and definitions to assess clinical outcome after endometriosis surgery
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Magnetic Resonance Imaging Compared with Rectal Endoscopic Sonography for the Prediction of Infiltration Depth in Colorectal Endometriosis
Arane Kim,Pedro Fernandez,Brigitte Martin,Laurent Palazzo,Lara Ribeiro-Parenti,Francine Walker,Margot Bucau,Helene Collinot,Dominique Luton,Martin Koskas +9 more
TL;DR: MRI is valuable for detecting endometriosis of the rectum but is less accurate in detecting submucosal/ mucosal involvement than RES, and RES is necessary to exclude bowel invasion.
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Laparoscopic Treatment of Deep Infiltrating Endometriosis Affecting the Rectosigmoid Colon: Nodulectomy or Segmental Resection?
TL;DR: The rationale for the surgical treatment of intestinal DIE affecting the rectosigmoid colon, defined as the lesion infiltrating at least the muscular layer of the bowel, is provided.
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Medium to long-term gastrointestinal outcomes following disc resection of the rectum for treatment of endometriosis using a validated scoring questionnaire.
Ada Ng,Phillip F Yang,Shing W. Wong,Thierry G. Vancaillie,Thierry G. Vancaillie,Surya Krishnan +5 more
TL;DR: To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrome after disc resection for deeply infiltrative endometriosis (DIE) using a validated scoring system.
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TL;DR: Hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma are all significantly more common in women with endometriosis than in women in the general USA population.