{"paper_id":"c6447f7b-340f-4130-8fa9-542d9d6feeb3","body_text":"Résumé\nL’endométriose digestive est définie par une infiltration endométriosique de la musculeuse pariétale du tube digestif et affecte 8 % à 30 % des patientes porteuses d’endométriose. Les localisations rectales et de la charnière rectosigmoïdienne sont les plus fréquentes et représentent jusqu’à 90 % de l’ensemble de ces lésions.\nDeux approches chirugicales existent dans la prise en charge de ces patientes que sont l’approche radicale et conservatrice.\nL’approche radicale a pour objectif la résection micro- et macroscopiquement complète des implants digestifs d’endométriose afin de réduire au minimum le risque de récidives digestives; elle consiste à réaliser de manière systématique des résections colorectales segmentaires et expose à un risque de séquelles fonctionnelles. L’approche conservatrice vise à réaliser chaque fois que possible des exérèses sélectives afin d’éviter les séquelles fonctionnelles, mais nécessite un traitement hormonal postopératoire pour éviter les récidives. Il n’existe à ce jour, aucune étude permettant de recommander une stratégie plutôt que l’autre. Les résultats de l’essai contrôlé randomisé ENDORE pourront prochainement apporter des informations sur les résultats fonctionnels digestifs chez les patientes opérées d’une endométriose rectale par résection colorectale ou chirurgie conservatrice.\nAbstract\nDigestive endometriosis is defined by infiltration of the muscular layer of bowel wall with endometriotic tissue. This condition affects 8 to 30% of the patients suffering from endometriosis. Rectal wall and low sigmoid are commonly affected (90% of digestive locations). Surgical approaches can be radical or conservative. Radical approach aims to resect the whole digestive implants of endometriotic tissue to offer the patient a maximum healing rate. In that case, colorectal resection is mandatory. Morbidity is fair but severe complications have been reported particularly on the functional results. Conservative approach aims to limit the resection and the risk of functional sequelae. There is no randomised trial to compare both surgical approaches. One ongoing trial “ENDORE” will answer this question by comparing radical resection to conservative approach.\nRéférences\nBailey HR, Ott MT, Hartendorp P (1994) Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum 37:747–53\nCampagnacci R, Perretta S, Guerrieri M, et al (2005) Laparoscopic colorectal resection for endometriosis. Surg Endosc 19:662–4\nVercellini P, Crosignani PG, Abbiati A, et al (2009) The effect of surgery for symptomatic endometriosis: the other side of the story. 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Traitement chirurgical de l’endométriose digestive : entre l’approche limitée et radicale. Colon Rectum 10, 174–180 (2016). https://doi.org/10.1007/s11725-016-0662-2\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s11725-016-0662-2\nMots clés\n- Endométriose digestive\n- Endométriose colorectale\n- Chirurgie\n- Résection segmentaire\n- Résection en pastille\n- Shaving rectal","source_license":"CC0","license_restricted":false}