Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results

Erdem, Suna; Imboden, Sara; Papadia, Andrea; Lanz, S.; Mueller, Christoph; Gloor, Beat; Worni, Mathias

doi:10.1097/dcr.0000000000001047

Cited by 23 publications

(21 citation statements)

References 35 publications

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“…One possible explanation to justify a longer stay in the public hospital was the high percentage of patients (more than 30%) where the surgery was converted to an open procedure. In our cohort of private patients, the conversion rate to laparotomy was 2%, which is very similar to other series 20 .…”

Section: ■ Discussionsupporting

confidence: 91%

Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital

Parra

Feitosa²,

Valério³

et al. 2020

Acta Cir. Bras.

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To compare the operative outcomes of laparoscopic surgical treatment for bowel endometriosis in a public teaching hospital versus in a private referral hospital. Methods: The indications for surgery, type and time of operation, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, and postoperative complications were evaluated. Results: One hundred eighty-one patients were included (150 patients, 82.9%, in a private hospital). In the private hospital, there were more patients with infertility [56% vs. 29%; P=0.01] as an indication for surgery) and segmental resection was more common in the private hospital (48% vs. 29%, p=0.05). The average operative time (211.9±83.4 minutes vs. 128 ± 55 minutes, p<0.001) as well as the length of hospital stay (3.97±1.7 days vs. 1.56±0.85 days, p<0.001) was higher in the public hospital; the rate of conversion to open surgery was significantly lower in the private hospital (2% vs. 32.3%, p<0.001). Operations performed at the public hospital were associated with higher rates of postoperative complications (Clavien-Dindo II and II) (38.7% x 11.3%, p=0.021; OR 3.2, CI 95% 1.2-8.0). Conclusion: Laparoscopic surgery in private centers was associated with reductions in major complications, surgical times, lengths of stay and rates of conversion to open surgery compared to that in public teaching hospitals.

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Section: ■ Discussionsupporting

confidence: 91%

Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital

Parra

Feitosa²,

Valério³

et al. 2020

Acta Cir. Bras.

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“…This distinguishes endometriosis from colorectal cancer that initially manifests with rectal bleeding. An important feature of rectal bleeding in endometriosis, along with their cyclic character, is its low intensity in the form of blood streaks in the stool, according to our study and the data reported by S. Erdem et al [10]. It must be remembered that the presence of blood or mucus in the feces requires, first of all, ruling out colorectal cancer.…”

Section: оRiginal Articlessupporting

confidence: 83%

Clinical and diagnostic features of retrocervical endometriosis

Almova¹,

Khilkevich²,

Chuprynin³

et al. 2018

Akusherstvo i ginekologiia

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Aim To investigate clinical and diagnostic features of patients with external genital (retrocervical) endometriosis (RCE). Material and methods The study comprised 44 patients with RCE, who were examined and underwent surgery at the V.I. Kulakov NMRC for OGP from October 2016 to December 2017. Patients were divided into four subgroups. Baseline diagnostic work-up included gynecological and somatic history and diagnostic imaging (transvaginal ultrasound (TVUS), pelvic magnetic resonance imaging (MRI), and colonoscopy). All patients underwent laparoscopic surgery. The type of surgery was chosen based on location, the depth of invasion in the affected organs, the degree of spread in the rectovaginal space, and co-occurrence of colon endometriosis. Results The main clinical manifestations of RCE included pelvic pain, dysmenorrhea, dyspareunia, infertility, and dyschezia. The absence or presence of the endometriotic infiltration of retrocervical adipose tissue, found during the bimanual and rectovaginal examination, does not rule out infiltrating rectosigmoid endometriosis. Pelvic MRI complements ultrasound clarifying the location and extent of the endomeriotic lesion, and involvement of the pelvic organs in the pathological process. Bloating, mucus in stool, dyschezia during menstruation, ultrasound, and MRI findings suggestive of colorectal endometriosis, warrant a colonoscopy. The intraoperative findings complement and refine the data obtained during the pre-operative diagnostic work-up. Conclusion Patients with RCE need comprehensive diagnostic evaluation with laparoscopy as the final stage, excision of endometriotic lesions, and histological confirmation of the diagnosis.

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“…En un estudio retrospectivo valoraron los resultados de incontinencia y dificultad en la evacuación posterior a la resección rectal por laparoscopia como parte del manejo de endometriosis profunda que comprometía la pared rectal, se hizo hasta 6 meses, de las 66 pacientes que se sometieron al procedimiento a 94% se les realizó laparoscopia, de las cuales 4% se convirtieron a laparotomía; 2% fueron por cirugía abierta, y además el 82% se les realizó anastomosis termino terminal, 2 pacientes presentaron insuficiencia de la anastomosis y encontraron que la dismenorrea y la dispareunia mejoraron sustancialmente en los síntomas de evacuación (p=0.002) e incontinencia (p=0.003) 31 .…”

Section: Tratamiento Quirúrgicounclassified

“…Manejo de la endometriosis rectovaginal. López Giraldo JF, et al 2019; 14 (1):[31][32][33][34][35][36][37][38] …”

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Manejo de la endometriosis rectovaginal: revisión de la literatura

2019

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La endometriosis es la presencia de tejido endometrial fuera del útero, es una enfermedad ginecológica benigna y crónica. una de las localizaciones en la presentacion de esta enfermedad es en la zona rectovaginal, como una de sus formas más severas, la cual se asocia a síntomas graves, como dolor pélvico crónico, dismenorrea y disquecia, con implicaciones importantes como alteraciones en la funcionalidad gastrointestinal y su asociación con alteraciones en la fertilidad de las pacientes que lo presentan. En este artículo realizamos una revisión de la literatura, acerca de esta patología, su presentación clínica, diagnóstico, alternativas en el tratamiento, tanto médico como quirúrgico, y las complicaciones que se pueden ver en este tipo de pacientes.

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Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results

Cited by 23 publications

References 35 publications

Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital

Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital

Clinical and diagnostic features of retrocervical endometriosis

Manejo de la endometriosis rectovaginal: revisión de la literatura

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