{"paper_id":"037afeae-4372-4e5b-adc2-02a77f2bca64","body_text":"Abstract\nAim\nEndometriosis is a frequent benign disease of women in reproductive age. An infiltration of the spatium rectovaginal is rare, but if it occurs, in up to 73% the rectum is involved. If there is the indication for surgery, a partial resection of the rectum might be necessary. This can be performed by a laparoscopic approach. It is the aim of this work to describe a patient population treated for endometriosis in the spatium rectovaginal by laparoscopic surgery.\nPatient population and methods\nA retrospective analysis of data from patients with endometriosis in rectum or sigma, which underwent a laparoscopic partial bowel resection in the years 2005–2006 at the Department of Obstetrics and Gynecology, University of Regensburg, was carried out.\nResults\nBetween 2005 and 2006, we performed a laparoscopic partial bowel resection in six patients with endometriosis. The mean age at diagnosis was 36.1 years (range 28–50 years) and 36.5 years (range 30–50 years) at surgery. All patients were nulligravida and 50% of the patients were infertile (since 1–6 years). The interval between the onset of symptoms and surgery ranged from a few weeks up to 2.5 years. Two-thirds of the patients had endocrine treatment before surgery. Three patients had a rectum resection, one a sigma resection and two had a combined rectum- and sigma resection. The mean duration of surgery was 201 min and mean hospital stay was 8 days. We saw one post-surgery bleeding at the enteroanastomosis. In that case two erythrocyte concentrates were necessary and the bleeding was stopped by rectoscopic intervention. All follow-up coloscopies were without pathological findings. One patient had a normal delivery after IVF/ICSI treatment.\nConclusions\nIf severe endometriosis needs a rectum resection then it can be done laparoscopically. This surgery should be performed in a specialized center. The duration of surgery, hospital stay and time of convalescence are short.\nSimilar content being viewed by others\nReferences\nBenagiano G, Brosens I (2006) History of adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:449–463\nKoninckx PR, Martin DC (1992) Deep endometriosis: a consequence of infiltration or retraction or possibly adenomyosis externa? Fertil Steril 58:924–928\nChapron C, Dubuisson JB (2001) Management of deep endometriosis. Ann N Y Acad Sci 943:276–280\nRedwine DB, Wright JT (2001) Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril 76:358–365\nPossover M, Diebolder H, Plaul K, Schneider A (2000) Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96:304–307\nDubernard G, Piketty M, Rouzier R, Houry S, Bazot M, Darai E (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21:1243–1247\nDarai E, Ackerman G, Bazot M, Rouzier R, Dubernard G (2007) Laparoscopic segmental colorectal resection for endometriosis: limits and complications. Surg Endosc 21:1572–1577\nBrouwer R, Woods RJ (2007) Rectal endometriosis: results of radical excision and review of published work. ANZ J Surg 77:562–571\nLyons SD, Chew SS, Thomson AJ, Lenart M, Camaris C, Vancaillie TG et al (2006) Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis. J Minim Invasive Gynecol 13:436–441\nDarai E, Marpeau O, Thomassin I, Dubernard G, Barranger E, Bazot M (2005) Fertility after laparoscopic colorectal resection for endometriosis: preliminary results. Fertil Steril 84:945–950\nFedele L, Bianchi S, Zanconato G, Bettoni G, Gotsch F (2004) Long-term follow-up after conservative surgery for rectovaginal endometriosis. Am J Obstet Gynecol 190:1020–1024\nBusacca M, Somigliana E, Bianchi S, De Marinis S, Calia C, Candiani M et al (2001) Post-operative GnRH analogue treatment after conservative surgery for symptomatic endometriosis stage III-IV: a randomized controlled trial. Hum Reprod 16:2399–2402\nYap C, Furness S, Farquhar C (2004) Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 2004:CD003678\nCampagnacci R, Perretta S, Guerrieri M, Paganini AM, De Sanctis A, Ciavattini A et al (2005) Laparoscopic colorectal resection for endometriosis. Surg Endosc 19:662–664\nConflict of interest statement\nThe author(s) indicated no potential conflicts of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nJuhasz-Böss, I., Lattrich, C., Fürst, A. et al. Severe endometriosis: laparoscopic rectum resection. Arch Gynecol Obstet 281, 657–662 (2010). https://doi.org/10.1007/s00404-009-1164-3\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-009-1164-3","source_license":"CC0","license_restricted":false}