{"paper_id":"ff140c5f-2950-429d-8729-ff4f1622097e","body_text":"ECR 2013 / C-1008\nValue of virtual colonoscopy in the prediction of surgical management of patients with rectal endometriosis.\nCongress:\nECR 2013\nPoster Number:\nC-1008\nType:\nScientific Exhibit\nKeywords:\nColonography CT, CT, Genital / Reproductive system female, Gastrointestinal tract, Obstruction / Occlusion\nAuthors:\nC. Da Costa1, H. Roman1, J. van der Wat2, M. Vassilief1, J.-J. Tuech1, C. Martin1, J.-N. Dacher1, C. Savoye-Collet1; 1Rouen/FR, 2Johannesburg/ZA\nDOI:\n10.1594/ecr2013/C-1008\nPurpose\nDeep pelvic endometriosis is a chronic and disabling disease,\nwhich affects young premenopausal active women.\nIntestinal location of endometriosis mainly affects the rectum or the sigmoid colon [1] and is regarded as one of the most severe form of the disease.\nTwo surgical techniques are currently available to treat intestinal involvements according to the severity of the lesions: radical intestinal resection or conservative surgery with simple nodule excision.\nFor teams performing first-line conservative surgery,\npreoperative evaluation of the degree of intestinal stenosis is essential to...\nMethods and Materials\nStudy design\nAll 60 patients operated for rectal endometriosis and undergoing preoperative VC between 2009-2012 were included.\nPatients’ characteristics,\nresults of VC and operative characteristics were retrospectively analyzed.\nVC preparation and technique\nThe day before the examination,\nall patients received a light colonic preparation with dihydrate disodium phosphate based laxative solution (Normacol â) to ensure adequate cleansing.\nThe examination started with limited pressure carbon dioxide insufflation after introduction of a flexible bulb catheter connected to an automated CO2 colon insufflator (E-Z-EM PROTOCO2L Colon Insufflator,\nBracco...\nResults\nAll patients underwent surgery in the University Hospital of Rouen.\nLaparoscopy was undertaken in all 60 patients and successfully perfomed in 55 (92.7%).\nFive (8.3%) patients required conversion,\nbecause of difficulties of excision of the nodule (n=3),\nor following vascular injury and ureteral injury in one case each.\nRadical resection was performed in 14 (23.3%) patients.\nOf the 46 (76.7%) patients undergoing conservative surgery,\n33 (55%) and 13 (21.7%) underwent shaving and full-thickness excision (Figure 8).\nThirty-two (53.3%) patients preoperatively displayed rectal narrowing including 11...\nConclusion\nVirtual colonoscopy is of major interest for teams practicing first line conservative surgeryas it brings valuable information in the evaluation of the digestive wall of patients with rectal endometriosis and therefore allows anticipation of the surgical technique to be undertaken.\nReferences\nDaraï E,\nBazot M,\nRouzier R,\nHoury S,\nDubernard G.\nOutcome of laparoscopic colorectal resection for endometriosis. Curr Opin Obstet Gynecol.\n2007 Aug;19(4):308-13.\nvan der Wat J,\nKaplan MD.\nModified virtual colonoscopy: a noninvasive technique for the diagnosis of rectovaginal septum and deep infiltrating pelvic endometriosis.J\nMinim Invasive Gynecol.\n2007 Sep-Oct;14(5):638-43.\nVassilieff M,\nSuaud O,\nCollet-Savoye C,\nDa Costa C,\nMarouteau-Pasquier N,\nBelhiba H,\nTuech JJ,\nMarpeau L,\nRoman H.\nComputed tomography-based virtual colonoscopy: an examination useful for the choice of the surgical management of...","source_license":"CC0","license_restricted":false}