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
More filters
Journal ArticleDOI
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
More filters
Journal ArticleDOI
Severe endometriosis: laparoscopic rectum resection
TL;DR: A retrospective analysis of data from patients with endometriosis in rectum or sigma, which underwent a laparoscopic partial bowel resection in the years 2005–2006 at the Department of Obstetrics and Gynecology, University of Regensburg, was carried out.
Journal Article
GnRH analogs versus expectant management in minimal and mild endometriosis-associated infertility.
TL;DR: Cumulative pregnancy rates at 12 months were comparable in the two groups and expectant management should be considered the most cost-effective option in the management of mild endometriosis-associated infertility.
Journal ArticleDOI
Laparoscopic treatment of deep pelvic endometriosis with rectal involvement.
TL;DR: Laroscopic resection of deep pelvic endometriosis with rectal involvement can be successful in improving digestive and gynecologic symptoms; however, this approach is challenging with a high rate of laparotomic conversion.