Assessment of Long-Term Bowel Symptoms After Segmental Resection of Deeply Infiltrating Endometriosis: A Matched Cohort Study

Soto, Enio; Catenacci, M.; Bedient, Carrie E.; Jelovsek, J. Eric; Falcone, Tommaso

doi:10.1016/j.jmig.2016.03.004

Cited by 22 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a series of 25 patients followed for 24 months [29], 5 of them presented with postoperative severe constipation following colorectal resection, which may be attributed to rectal neurologic sequelae, stenosis of the anastomosis, colorectal intussusception through the anastomosis, and slow-transit constipation. Another study [30], showed that surgery with segmental bowel resection for IE can be associated with new bowel symptoms such as abdominal pain, incomplete bowel movements, and/or false alarms, without worsening of constipation or fecal incontinence.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis

Bassi

Andres

Bassi

et al. 2020

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis

Bassi

Andres

Bassi

et al. 2020

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

“…noticed a trend in the relapse of symptoms 12 months after the surgery, a period at which Kössi et al 16 identified a 27% prevalence of constipation , . Another relevant study found a significant worsening of constipation symptoms in patients who underwent segmental resections compared to patients in a control group 27 .…”

Section: Discussionmentioning

confidence: 95%

“…Minor and shallower lesions are eligible to less aggressive colorectal resections, but in the case of more extensive and circumferential or multifocal involvement, these techniques may not be an option and segmental resection may be the only possible alternative 4 . Conversely, segmental resections may be responsible for the appearance of new colorectal symptoms and complications, and possibly higher postoperative morbidity 27 .…”

Section: Introductionmentioning

confidence: 99%

Late Impact of the Laparoscopic Treatment of Deep Infiltrating Endometriosis With Segmental Colorectal Resection

Rocha

Albuquerque

Schmidt

et al. 2018

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

Background: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. Aim: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. Methods: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. Results: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. Conclusion: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.

show abstract

“…64 And although pain clearly improves after surgery for DIE, a matched cohort study with median follow-up over 10 years of 36 cases and 35 controls with DIE demonstrated that cases reported significantly more new bowel symptoms following surgery (58% in cases vs. 14% of controls, p ¼ 0.001) including abdominal pain, incomplete bowel emptying, and/or "false alarms." 68 Despite these reports, patients did not have worsening constipation or fecal incontinence than their controls who did not undergo bowel resection. Individualized counseling is recommended for DIE identified prior to surgery and involves careful discussion with the patient regarding the risks and benefits of this type of bowel surgery.…”

Section: Other Conservative Surgery Optionsmentioning

confidence: 91%

Surgical Management of Endometriosis in Patients with Chronic Pelvic Pain

Flyckt

Kim

Falcone³

2017

Semin Reprod Med

Self Cite

View full text Add to dashboard Cite

Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis. Appendectomy may be considered prophylactically at the time of the surgery for pelvic pain, although more studies are needed. For deep infiltrating endometriosis, the risks of aggressive bowel surgery must be weighed against the benefits of clear pain reduction. Postoperative medical suppressive therapy is strongly recommended to prolong symptom-free intervals of this chronic disease. As definitive therapy, hysterectomy can be helpful especially when combined with endometriosis excision. When performing hysterectomy, bilateral oophorectomy should be given careful consideration, as this procedure leads to premature surgical menopause and may not decrease the possibility of reoperation and persistence of symptoms in patients aged 30 to 39 years with chronic pain.

show abstract

Assessment of Long-Term Bowel Symptoms After Segmental Resection of Deeply Infiltrating Endometriosis: A Matched Cohort Study

Cited by 22 publications

References 27 publications

Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis

Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis

Late Impact of the Laparoscopic Treatment of Deep Infiltrating Endometriosis With Segmental Colorectal Resection

Surgical Management of Endometriosis in Patients with Chronic Pelvic Pain

Contact Info

Product

Resources

About