How to Manage Bowel Endometriosis: The ETIC Approach

Alabiso, G.; Alio, L.; Arena, Saverio; Prun, Allegra Barbasetti di; Bergamini, Valentino; Berlanda, Nicola; Busacca, Mauro; Candiani, Massimo; Centini, Gabriele; Cello, Annalisa Di; Exacoustòs, C.; Fedele, Luigi; Gabbi, Laura; Geraci, E.; Lavarini, E.; Incandela, Domenico; Lazzeri, Lucia; Luisi, Stefano; Maiorana, Antonio; Maneschi, Francesco; Mattei, Alberto; Muzii, Ludovico; Pagliardini, Luca; Perandini, Alessio; Perelli, Federica; Pinzauti, Serena; Remorgida, Valentino; Sánchez, Ana M.; Seracchioli, Renato; Somigliana, Edgardo; Tosti, Claudia; Venturella, Roberta; Vercellini, Paolo; Viganò, Paola; Vignali, Michele; Zullo, Fulvio; Zupi, Errico

doi:10.1016/j.jmig.2015.01.021

Cited by 30 publications

(27 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is frequently diagnosed in the third decade of life, affecting 10-12% women of reproductive age. 1 The gold standard for diagnosis of endometriosis is visual inspection by laparoscopy. An experienced surgeon, familiar with the disease process and its varying clinical presentation, should perform the laparoscopy so as to safeguard that cases are not missed or overlooked.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, studies have demonstrated a possible role of oxidative stress and reactive oxygen species which appear to trigger an inflammatory process that may contribute to the pathogenesis of endometriosis. 1,17 DE is an estrogen-dependent disease; therefore, two phenomena can lead to spontaneous regression or symptom improvement, pregnancy, and menopause. Nevertheless, post-menopausal deep endometriosis does exist and pregnancy can be complicated by the presence of endometriosis.…”

Section: Introductionmentioning

confidence: 99%

“…Symptoms can be controlled initially with medication unless symptoms of bowel obstruction occur, or pain becomes intolerable. 1,23 Preoperative clinical and imaging assessment is essential to stage the disease accurately obtaining precise information regarding disease progression to correctly guide decision-making regarding the pros and cons of both medical and surgical management. Taking into account the complications associated with surgery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

Habib¹,

Centini²,

Lazzeri³

et al. 2020

IJWH

Self Cite

View full text Add to dashboard Cite

Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits (constipation/diarrhoea) dyschezia, dysmenorrhoea and dyspareunia in addition to infertility. To date, there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis. Several techniques have been proposed including transvaginal and/or transrectal ultrasonography, magnetic resonance imaging, and double-contrast barium enema. These different imaging modalities provide greater information regarding presence, location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning. In cases where surgical management is indicated, surgery should be performed by experienced surgeons, in centres with access to multidisciplinary care. Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible, whilst at the same time preserving organ function. In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

Habib¹,

Centini²,

Lazzeri³

et al. 2020

IJWH

Self Cite

View full text Add to dashboard Cite

show abstract

“…Unfortunately, in more than 80% of cases, the decision to perform resection is made during surgery . Precise diagnosis is therefore essential in order to allow the surgeon to obtain preoperative informed consent and to organize a multidisciplinary surgical team . Some experts believe that bowel resection cannot be planned before surgery, and a conservative approach should be regarded as first line treatment .…”

Section: Introductionmentioning

confidence: 99%

“…8 Precise diagnosis is therefore essential in order to allow the surgeon to obtain preoperative informed consent and to organize a multidisciplinary surgical team. 9 Some experts believe that bowel resection cannot be planned before surgery, and a conservative approach should be regarded as first line treatment. 10 In 2009, Tarjanne et al found that previous surgery for endometriosis or intestinal symptoms were risk factors for radicality, while preoperative use of combined oral contraceptives was associated with a lower risk of bowel resection.…”

Section: Introductionmentioning

confidence: 99%

Defining probabilities of bowel resection in deep endometriosis of the rectum: Prediction with preoperative magnetic resonance imaging

Perandini

Montemezzi

et al. 2017

J of Obstet and Gynaecol

Self Cite

View full text Add to dashboard Cite

show abstract

The implications of the anatomy of the nerves and vessels in the treatment of rectosigmoid endometriosis

et al. 2023

Self Cite

View full text Add to dashboard Cite

Endometriosis is a common benign gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus. It can be defined as endometrioma, superficial peritoneal endometriosis or deep infiltrating endometriosis (DIE) depending on the location and the depth of infiltration of the organs. In 5%–12% of cases, DIE affects the digestive tract, frequently involving the distal part of the sigmoid colon and rectum. Surgery is generally recommended in cases of obstructive symptoms and in cases with pain that is non‐responsive to medical treatment. Selection of the most optimal surgical technique for the treatment of bowel endometriosis must consider different variables, including the number of lesions, eventual multifocal lesions, as well as length, width and grade of infiltration into the bowel wall. Except for some major and widely accepted indications regarding bowel resection, established international guidelines are not clear on when to employ a more conservative approach like rectal shaving or discoid resection, and when, instead, to opt for bowel resection. Damage to the pelvic autonomic nervous system may be avoided by detection of the middle rectal artery, where its relationship with female pelvic nerve fibers allows its use as an anatomical landmark. To reduce the risk of potential vascular and nervous complications related to bowel resection, a less invasive approach such as shaving or discoid resection can be considered as potential treatment options. Additionally, the middle rectal artery can be used as a reference point in cases of upper bowel resection, where a trans mesorectal technique should be preferred to prevent devascularization and denervation of the bowel segments not affected by the disease.

show abstract

How to Manage Bowel Endometriosis: The ETIC Approach

Cited by 30 publications

References 90 publications

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

Defining probabilities of bowel resection in deep endometriosis of the rectum: Prediction with preoperative magnetic resonance imaging

The implications of the anatomy of the nerves and vessels in the treatment of rectosigmoid endometriosis

Contact Info

Product

Resources

About