Combined Transvaginal/Transabdominal Pelvic Ultrasonography Accurately Predicts the 3 Dimensions of Deep Infiltrating Bowel Endometriosis Measured after Surgery: A Prospective Study in a Specialized Center

Di Giovanni A, A. Di Giovanni, Alessandra Di Giovanni, Lucia Casarella, Casarella L, Marina Coppola, Iuzzolino D, Domenico Iuzzolino, Marianna Rasile, Rasile M, Mario Malzoni, Malzoni M
Journal of Minimally Invasive Gynecology · 2018 · vol. 25(7) , pp. 1231–1240 · doi:10.1016/j.jmig.2018.03.003 · PMID:29545217 · W2793023914
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This prospective study in a specialized center found that combined transvaginal and transabdominal pelvic ultrasonography accurately predicted the three-dimensional measurements of deep infiltrating bowel endometriosis determined after surgery.

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Abstract

STUDY OBJECTIVE: To assess the sensitivity and accuracy of combined transvaginal/ transabdominal ultrasonography (TV/TA US) for evaluation of deep infiltrating bowel endometriosis nodules measured after surgery. DESIGN: Prospective study (Canadian Task Force classification II.1). SETTING: A center for advanced endoscopic gynecologic surgery. PATIENTS: All women undergoing laparoscopic surgery and scheduled for segmental resection for clinically suspected bowel endometriosis between January 2014 and December 2016. INTERVENTIONS: In all women with clinically suspected bowel endometriosis, a US scan was performed before surgery to detect and measure the 3 diameters of bowel endometriotic lesions: longitudinal, anteroposterior, and transverse. These diameters were compared with those obtained by direct measurement on a fresh specimen. The sensitivity and specificity values of US evaluation were calculated, with 95% confidence intervals. MEASUREMENTS AND MAIN RESULTS: The sensitivity and specificity of TV/TA US in the 328 patients of this study were 100% when rectal endometriotic lesions were investigated. The specificity was 100%, whereas the sensitivity decreased to 91.4% when sigmoid lesions were investigated. Bowel muscularis infiltration was histologically confirmed in all cases in which endometriotic lesions were detected by US (284 of 284; 100%). All missed sigmoid lesions (12 of 296) were located >25 cm from the anal verge. The mean diameters of endometriotic nodules calculated by US evaluation and by direct measurement on the fresh specimen were 43.19 × 19.87 × 10.79 mm and 42.76 × 19.64 × 10.62 mm, respectively, with no statistically significant differences between the 2 methods. CONCLUSION: We believe that US can be considered an accurate diagnostic technique for the evaluation of deep infiltrating bowel endometriosis when performed by a dedicated experienced sonographer in a specialized center.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Intestinal Diseases Ultrasonography Ultrasonography Ultrasonography Adult Adult Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans Intestinal Diseases Intestinal Diseases Intestinal Diseases Intestinal Diseases Laparoscopy

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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