Bowel endometriosis: Colorectal surgeon’s perspective in a multidisciplinary surgical team

Albert Wolthuis, Albert M Wolthuis, Christel Meuleman, Carla Tomassetti, Thomas D'Hooghe, Anthony de Buck van Overstraeten, André D'Hoore
World journal of gastroenterology · 2014 · vol. 20(42) , pp. 15616 · doi:10.3748/wjg.v20.i42.15616 · PMID:25400445 · W2029041152
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This paper reviews bowel endometriosis from a colorectal surgeon's viewpoint, detailing diagnosis, multidisciplinary laparoscopic treatment, surgical techniques like disc excision or resection, and good long-term outcomes.

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Abstract

Endometriosis is a gynecological condition that presents as endometrial-like tissue outside the uterus and induces a chronic inflammatory reaction. Up to 15% of women in their reproductive period are affected by this condition. Deep endometriosis is defined as endometriosis located more than 5 mm beneath the peritoneal surface. This type of endometriosis is mostly found on the uterosacral ligaments, inside the rectovaginal septum or vagina, in the rectosigmoid area, ovarian fossa, pelvic peritoneum, ureters, and bladder, causing a distortion of the pelvic anatomy. The frequency of bowel endometriosis is unknown, but in cases of bowel infiltration, about 90% are localized on the sigmoid colon or the rectum. Colorectal involvement results in alterations of bowel habits such as constipation, diarrhea, tenesmus, dyschezia, and, rarely, rectal bleeding. Differential diagnosis must be made in case of irritable bowel syndrome, solitary rectal ulcer syndrome, and a rectal tumor. A precise diagnosis about the presence, location, and extent of endometriosis is necessary to plan surgical treatment. Multidisciplinary laparoscopic treatment has become the standard of care. Depending on the size of the lesion and site of involvement, full-thickness disc excision or bowel resection needs to be performed by an experienced colorectal surgeon. Long-term outcomes, following bowel resection for severe endometriosis, regarding pain and recurrence rate are good with a pregnancy rate of 50%.

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Condition tags

mesh:D004715endometriosisbowel_endometriosisirritable_bowel_syndrome

MeSH descriptors

Digestive System Surgical Procedures Endometriosis Intestinal Diseases Laparoscopy Patient Care Team Cooperative Behavior Diagnostic Imaging Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Female Humans Interdisciplinary Communication Intestinal Diseases Intestinal Diseases Laparoscopy Laparoscopy Predictive Value of Tests Treatment Outcome

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (57)

Cited by (50)

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