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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ESHRE guideline: management of women with endometriosis
Gerard A.J. Dunselman,Nathalie Vermeulen,Christian M. Becker,Carlos Calhaz-Jorge,B. De Bie,O. Heikinheimo,L. Kiesel,Annemiek W. Nap,Andrew M. Prentice,Ertan Saridogan,David Soriano,Willianne L.D.M. Nelen +11 more
TL;DR: This guideline was produced by a group of experts in the field using the structured methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations.
Journal ArticleDOI
Deep endometriosis: definition, diagnosis, and treatment
TL;DR: Deep endometriosis, defined as adenomyosis externa, is a rarely a progressive and recurrent disease, while bowel resection should be avoided, except for the sigmoid.
Journal ArticleDOI
Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management
Mauricio Simões Abrão,Felice Petraglia,Tommaso Falcone,J Keckstein,Yutaka Osuga,Charles Chapron +5 more
TL;DR: In women with deep endometriosis, surgery is the therapy of choice for symptomatic patients when deep lesions do not improve with a medical treatment.
Iconographies supplémentaires de l'article : Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis
Emile Daraï,Isabelle Thomassin,Emmanuel Barranger,Romain Detchev,Annie Cortez,Sydney Houry,Marc Bazot +6 more
TL;DR: The results suggest that laparoscopic segmental colorectal resection for endometriosis is feasible but carries a risk of major postoperative complications.
References
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Laparoscopic endometriosis treatment: is it better?**Received award as Prize Paper by a Practicing Physician and was presented at the 39th Annual Meeting of the Pacific Coast Fertility Society, Indian Wells, California, April 10 to 14, 1991.
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Fertility after laparoscopic management of deep endometriosis infiltrating the uterosacral ligaments
TL;DR: Encouraging preliminary results show that in a context of infertility it is reasonable to associate classic treatment for endometriosis with resection of deep endometricriotic lesions infiltrating the uterosacral ligaments.
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Should the Gynecologist Perform Laparoscopic Bowel Resection to Treat Endometriosis? Results Over 7 Years in 168 Patients
R.M.A. Pereira,A. Zanatta,C.D. Preti,Fernando José Felipe de Paula,Eduardo L.A. Motta,Paulo C. Serafini +5 more
TL;DR: Surgery to treat bowel endometriosis can be safely and efficiently performed by the gynecologic pelvic surgeon and meticulous training and a multidisciplinary approach to comprehensive operative care are necessary.
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Analysis of clinical fertility trials: a methodologic review
Edward E. Wallach,David L. Olive +1 more
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Laparoscopic Management of Rectal Endometriosis
Anita K. Jatan,Michael J. Solomon,Michael J. Solomon,Jane M. Young,Michael Cooper,Nimalan Pathma-Nathan +5 more
TL;DR: Patients with complex endometriosis of the rectum can be safely managed laparoscopically using a multidisciplinary approach, and a history of rectal pain during defecation that occurs only during menstruation is predictive of females with more extensive rectal disease.