Our study adds to the growing body of literature describing colorectal resection for severe endometriosis. Overall, the surgery appeared to be well tolerated, demonstrating the role for this surgery.

Type 2 diabetes (T2DM) is associated with pancreatic islet dysfunction. Loss of β-cell identity has been implicated via dedifferentiation or conversion to other pancreatic endocrine cell types. How these transitions contribute to the onset and progression of T2DM is unknown. The aims of this study were to determine the degree of epithelial-to-mesenchymal transition occurring in α and β cells and to relate this to diabetes-associated (patho)physiological conditions. The proportion of islet cells expressing the mesenchymal marker vimentin was determined by immunohistochemistry and quantitative morphometry in specimens of pancreas from human donors with T2DM ( = 28) and without diabetes (ND, = 38) and in non-human primates at different stages of the diabetic syndrome: normoglycaemic (ND, = 4), obese, hyperinsulinaemic (HI, = 4) and hyperglycaemic (DM, = 8). Vimentin co-localised more frequently with glucagon (α-cells) than with insulin (β-cells) in the human ND group (1.43% total α-cells, 0.98% total β-cells, median; < 0.05); these proportions were higher in T2DM than ND (median 4.53% α-, 2.53% β-cells; < 0.05). Vimentin-positive β-cells were not apoptotic, had reduced expression of Nkx6.1 and Pdx1, and were not associated with islet amyloidosis or with bihormonal expression (insulin + glucagon). In non-human primates, vimentin-positive β-cell proportion was larger in the diabetic than the ND group (6.85 vs 0.50%, medians respectively, < 0.05), but was similar in ND and HI groups. In conclusion, islet cell expression of vimentin indicates a degree of plasticity and dedifferentiation with potential loss of cellular identity in diabetes. This could contribute to α- and β-cell dysfunction in T2DM.

Intestinal involvement in endometriosis is thought to occur in up to 12% of all endometriosis cases. While colorectal resection is being increasingly advocated as a feasible management option in patients with severe disease, there still remains significant resistance towards this surgery. This article aims to review the current literature to determine the pain and fertility outcomes following segmental bowel resection for colorectal endometriosis.

Laparoscopic cervical cerclage proved technically feasible and safe for a surgeon trained in laparoscopic suturing methods.

12% of women diagnosed with endometriosis (3). The most commonly involved sites of intestinal endometriosis are the rectum and rectosigmoid junction (4). The management of colorectal endometriosis presents several challenges. Diagnosis is often difficult, as clinical manifestations vary considerably and are often non-specific. Features may include dysmenorrhoea, chronic pelvic pain, infertility, dyspareunia and adnexal masses, or relate more specifically to colorectal involvement such as constipation, rectal bleeding, tenesmus and dyschezia (5). There have been rare cases reported of colorectal endometriosis presenting with bowel obstruction (6, 7), colonic perforation (8) and intussusception (9). Medical management of colorectal endometriosis is not curative and may be associated with considerable side effects (10, 11). Various surgical options to treat severe disease have been described in the literature, including bowel disc excision