{"paper_id":"76fe5b04-7aa4-488c-8152-9418d72f7307","body_text":"Abstract\nBackground\nThe rectosigmoid colon is affected by deep pelvic endometriosis in 3–37% of cases. In the past, treatment of the affected gastrointestinal tract generally required conversion to conventional surgery. We describe our experience with complete laparoscopic management of deep pelvic endometriosis with bowel involvement.\nMethods\nFrom March 1995 to March 2003, 29 consecutive patients with endometriosis requiring laparoscopic intervention were evaluated. In seven patients (24%) colorectal involvement was identified prior to the operation. A low anterior resection was performed in four patients (57%) and a sigmoid resection in three (43%). In all cases, colonoscopy showed a normal mucosa. In all cases, treatment consisted of resection of the bowel involved together with the excision of all other implants. Data analysis included age, previous abdominal operations, previous history of endometriosis, operative time, conversion rate, complications, length of stay, and pain relief.\nResults\nThere were seven patients with colorectal involvement whose median age was 32.8 years (range, 28–40), with a history of previous abdominal operation in two (28%). Preoperative symptoms were as follow: dysmenorrea in four patients (57%), dyspareunia in four (57%), pelvic pain in seven (100%), rectal bleeding in one (14%), and tenesmus in five (71%). Mean operative time was 190 min (range, 165–230). Length of stay was 8.3 days (range, 7–11). There were no anastomotic leak and no major postoperative complication. One patient had temporary urinary retention. At a median follow-up of 38.7 months (range, 1–84), complete relief of pelvic symptoms was achieved in five patients (71%), and there was improvement in one patient. In one patient complaining of persistent pain, a new colonic implant was diagnosed two years after the surgery requiring reoperation.\nConclusions\nThe results show that provided that the surgeon is highly skilled in laparoscopy, laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement is feasible and effective in nearly all patients.\nSimilar content being viewed by others\nReferences\nRB Cattel (1937) ArticleTitleEndometriosis of the colon and rectum with intestinal obstruction N Engl J Med 217 9–16\nGR Collin JC Russel (1990) ArticleTitleEndometriosis of the colon: its diagnosis and management Am Surg 56 275–279 Occurrence Handle1:STN:280:By%2BB2c%2FlsV0%3D Occurrence Handle2334065\nC Coronado RR Franklin EC Lotze HR Bailey CT Valdes (1990) ArticleTitleSurgical treatment of symptomatic colorectal endometriosis Fertil Steril 3 411–416\nB Graham WP Mazier (1988) ArticleTitleDiagnosis and management of endometriosis of the colon and rectum Dis Colon Rectum 31 952–956 Occurrence Handle1:STN:280:BiaC3cnoslY%3D Occurrence Handle3215101\nLA Gray (1960) ArticleTitleEndometriosis Clin Obset Gynecol 3 472–479\nEL Jenkinson WH Brown (1943) ArticleTitleEndometriosis: a study of 117 cases with special reference to constricting lesions of rectum and sigmoid colon J Am Med Assoc 122 349–354\nBL Jerby H Kessler T Falcone JW Milsom (1999) ArticleTitleLaparoscopic management of colorectal endometriosis Surg End 13 1125–1128 Occurrence Handle1:STN:280:DC%2BD3c%2FivVCitA%3D%3D\nL Kiesel K Bertges TR Holst (1989) ArticleTitleTreatment of endometriosis Arch Gynecol Obstet 245 937–940 Occurrence Handle1:STN:280:By%2BD38rktVI%3D Occurrence Handle2679444\nGL Kratzer EP Salvati (1955) ArticleTitleCollective review of endometriosis of the colon obstet Gynecol Am J surg 90 866–869 Occurrence Handle1:STN:280:CymD3M%2FovF0%3D\nSM Markham SE Carpenter JA Rock (1989) ArticleTitleExtrapelvic endometriosis Clin North Am 16 193–219 Occurrence Handle1:STN:280:BiaA3MvmvFI%3D\nA Martin-Duce M Diez JM Muguerza JL Gallego A Gutierrez G Garces J Granell (1996) ArticleTitleAcute small bowel obstruction caused by endometriosis Eur J Surg 9 747–749\nB McSwain RJ Linn RL Haley SuffixJr RH Franklin (1974) ArticleTitleEndometriosis of the colon: report of 14 patients requiring partial colectomy South Med 67 651–658 Occurrence Handle1:STN:280:CSuC28josFE%3D\nC Nezhat S Malik J Osias F Nezhat CH Nezhat (2002) ArticleTitleLaparoscopic management of 15 patients with infiltrating endometriosis of the bladder and a case of primary intravescical endometrioid adenosarcoma Fertil Steril 4 872–879\nC Nezhat F Nezhat E Pennington CH Nezhat W Ambroze (1994) ArticleTitleLaparoscopic disk excision and primary repair of the anterior rectal wall for the treatment of full-thickness bowel endometriosis Surg End 8 682–685 Occurrence Handle1:STN:280:ByuA3sjis10%3D\nC Nezhat E Pennington F Nezhat SL Silfen (1991) ArticleTitleLaparoscopically assisted anterior rectal wall resection and reanastomosis for deply infiltrating endometriosis Surg Laparosc Endosc 2 106–108\nF Nezhat C Nezhat E Pennington W Ambroze (1992) ArticleTitleLaparoscopic segmental resection for infiltrating endometriosis of the rectosigmoid colon: a preliminary report Surg Laparosc Endosc 3 212–216\nJL Ponka BE Brush CP Hodgkinson (1973) ArticleTitleColorectal endometriosis Dis Colon Rectum 16 490–498 Occurrence Handle1:STN:280:CSuD2s3kslA%3D Occurrence Handle4769225\nJB Prystowsky SJ Stryker GT Ujiki SM Poticha (1988) ArticleTitleGastrointestinal endometriosis: incidence and indications for resection Arch Surg 123 855–858 Occurrence Handle1:STN:280:BieB2M7ivVI%3D Occurrence Handle3382351\nVJ Scarmato et al. (2000) ArticleTitleHeal endometriosis: radiographic findings in five cases Radiology 214 509–512 Occurrence Handle1:STN:280:DC%2BD3c7jvVKluw%3D%3D Occurrence Handle10671601\nJ Schroder M Lohnert JM Doniec P Dohrmann (1997) ArticleTitleEndoluminal ultrasound diagnosis and operative management of rectal endometriosis Dis Colon Rectum 5 614–617\nKK Singh AM Lessells DJ Adam C Jordan WF Miles IM Macintyre JD Greig (1995) ArticleTitlePresentation of endometriosis to general surgeons: a 10 years experience Br J Surg 10 1349–1351\nJC Weed JE Ray (1987) ArticleTitleEndometriosis of the bowel Obstet Gynecol 69 727–730 Occurrence Handle1:STN:280:BiiB3c3ntlI%3D Occurrence Handle3574800\nTJ Williams JH Pratt (1977) ArticleTitleEndometriosis in 1000 consecutive celiotomies: incidence and management Am J Obstet Gynecol 129 245–250 Occurrence Handle1:STN:280:CSiB28vitFM%3D Occurrence Handle900194\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nCampagnacci, R., Perretta, S., Guerrieri, M. et al. Laparoscopic colorectal resection for endometriosis. Surg Endosc 19, 662–664 (2005). https://doi.org/10.1007/s00464-004-8710-7\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00464-004-8710-7","source_license":"CC0","license_restricted":false}