Laparoscopic Colorectal Resection for Bowel Endometriosis

Minelli, Luca; Fanfani, Francesco; Fagotti, Anna; Ruffo, Giacomo; Ceccaroni, Marcello; Mereu, Liliana; Landi, Stefano; Pomini, Paola; Scambia, Giovanni

doi:10.1001/archsurg.2008.555

Cited by 151 publications

(26 citation statements)

References 25 publications

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“…Our results show that a preoperative morphologic evaluation of the nodule, by measuring its short axis and the degree of luminal stenosis, answers with high degree of accuracy to the main question of the surgeon, whether an intestinal resection will be required or not. Our findings are in line with large surgical series where colorectal resections were demanded in nodules > 2 cm with a degree of stenosis > 50% [33, 34]. However, predictive cut-off values that we found in our series seem to be smaller (11 mm and 30%) than those expected by bowel surgeons.…”

Section: Discussionsupporting

confidence: 91%

Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis

Scardapane

Lorusso

Francavilla

et al. 2017

BioMed Research International

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Purpose To define if MRI findings in patients with deep pelvic endometriosis (DPE) may be predictive for the need of bowel resection. Material and Methods A retrospective survey of 196 pelvic MRIs of women who received laparoscopic procedures for DPE was carried out. A pelvic MRI was performed in all patients: it consisted in T2w-TSE sequences in axial, sagittal, and coronal planes and T1w and THRIVE sequences in the axial plane; the exam was completed by MR-Colonography. Intestinal lesions were measured in short and long axis and the degree of stenosis was established. A multivariate logistic regression was used to identify the predictors of intestinal resection. Results 57/196 patients received an intestinal resection. Multivariate logistic regression demonstrated a predictive value of short axis (Odds-Ratio = 2.29, p = 0.011) and stenosis (Odds-Ratio = 1.20, p = 0.003). ROC analysis showed that a cut-off value of 11 mm for the short axis and 30% for the stenosis may correctly classify, respectively, 96,94% (sensitivity 92,9% and specificity 98,56%) and 97,96% (sensitivity 94,74% and specificity 99,3%) of the cases. Conclusion The presence of an endometriotic rectal nodule > 11 mm in short axis causing a stenosis > 30% in pelvic MRI reliably predicts the need of a rectal resection.

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Section: Discussionsupporting

confidence: 91%

Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis

Scardapane

Lorusso

Francavilla

et al. 2017

BioMed Research International

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“…While some studies evidenced a significant QOL improvement in women treated with colorectal segmental resection [38-41], others suggested nodule excision or shaving, as a first choice procedure. These authors retrieved an increased risk of postoperative complications together with de novo intestinal and urological symptoms appearance in patients submitted to segmental intestinal resection [37,40,42-44]).…”

Section: Discussionmentioning

confidence: 99%

Does laparoscopic management of deep infiltrating endometriosis improve quality of life? A prospective study

Mabrouk

Montanari

Guerrini

et al. 2011

Health Qual Life Outcomes

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BackgroundDeep infiltrating endometriosis (DIE) can affect importantly patients' quality of life (QOL). The aim of this study is to evaluate the impact of the laparoscopic management of DIE on QOL after six months from treatment.MethodsIt is a prospective cohort study. In a tertiary care university hospital, between April 2008 and December 2009, 100 patients underwent laparoscopic management of DIE and completed preoperatively and 6-months postoperatively a QOL questionnaire, the short form 36 (SF-36).Quality of life was measured through the SF-36 scores. Intra-operative details of disease site, number of lesions, type of intervention, period of hospital stay and peri-operative complications were noted.ResultsSix months postoperatively all the women had a significant improvement in every scale of the SF-36 (p < 0,0005). Among patients with intestinal DIE, significant differences in postoperative scores of SF-36 were not detected between patients submitted to nodule shaving and segmental resection (p > 0.05). There was no significant difference in the SF-36 scores at 6 months from surgery between patients who received postoperative medical treatment and patients who did not (p > 0.05).ConclusionsLaparoscopic excision of DIE lesions significantly improves general health and psycho-emotional status at six months from surgery without differences between patients submitted to intestinal segmental resection or intestinal nodule shaving.

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“…Kljub naraščajočemu številu poročil o uspešnosti in varnosti laparoskopske resekcije črevesa (20,21,22) pa ostaja odprto vprašanje, ali je laparoskopska resekcija rektosigme pri simptomatski GIE črevesa upravičena. Številni avtorji poročajo, da so bolj konzervativni posegi, kot sta postrganje (shaving) in izrezanje nodusa ali diskoidna resekcija, enako učin-koviti, z manj resnimi zapleti ter krajšim časom operiranja (17,23,24).…”

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Kakovost življenja pred in po laparoskopski resekciji črevesa zaradi globoke infiltrativne endometrioze

2017

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Background: Te purpose of the study was to determine the quality of life in patients with bowel endometriosis before and afer laparoscopic bowel resection.Material and methods: In the retrospective study we included 91 patients who underwent laparoscopic resection of the bowel aﬀected by endometriosis at the Unit for Reproduction and the Unit for Gynecology, Department of Obstetrics and Gynecology Ljubljana, in the period from 2002 to 2011. Te study was retrospective. Te patients were sent a questionnaire regarding the symptoms before surgery and the eﬀect of surgery on bowel symptoms, painful menstruation, painful sexual intercourse, chronic pelvic pain and quality of life before and afer surgery; 76 (83.5 %) patients replied to the questionnaire.Results: Before surgery, 72 (94.7 %) patients reported painful menstruation. Improvement or complete relief afer surgery was registered in 57 (79.1 %). Out of 60 (78.9 %) patients who had painful sexual intercourse before surgery, 49 (81.7 %) reported improvement or complete relief afer surgery. Bowel symptoms, present in 52 (68.4 %) patients before surgery, improved or completely disappeared in 48 (92.4 %) afer surgery. Chronic pelvic pain, present in 53 (69.7 %) before surgery, decreased or did not exist any more in 45 patients (86.5 %). Te quality of life before surgery was very poor in 32 patients (42.1 %), and poor in 21 patients (27.8 %). Afer the operation, the quality of life was reported as improved in 22 (28.9 %) and signifcantly improved in 42 (55.3 %).Conclusions: Laparoscopic bowel resection, indicated in extensive symptomatic endometriosis, signifcantly improves the patients’ quality of life.

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Laparoscopic Colorectal Resection for Bowel Endometriosis

Cited by 151 publications

References 25 publications

Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis

Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis

Does laparoscopic management of deep infiltrating endometriosis improve quality of life? A prospective study

Kakovost življenja pred in po laparoskopski resekciji črevesa zaradi globoke infiltrativne endometrioze

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