Choosing the right technique for deep endometriosis

Michelle Nisolle; Nisolle M; Brichant G; Géraldine Brichant; Linda Tebache; Tebache L

doi:10.1016/j.bpobgyn.2019.01.010

Choosing the right technique for deep endometriosis

Michelle Nisolle, Nisolle M, Brichant G, Géraldine Brichant, Linda Tebache, Tebache L

Best practice & research. Clinical obstetrics & gynaecology · 2019 · vol. 59 , pp. 56–65 · doi:10.1016/j.bpobgyn.2019.01.010 · PMID:30824210 · W2911607806

review OA: closed CC0 ⤵ 13 in-corpus citations

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This paper discusses deep endometriosis and its surgical management, with a focus on choosing the optimal technique based on lesion location and extent.

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Abstract

The surgical management of bowel endometriosis is a real challenge. In addition to the fact that only symptomatic patients should undergo surgery, no consensus has been approved in the literature. Among the surgical techniques, the surgeon has to choose between rectal shaving, disc excision, or segmental colorectal resection. All those procedures are associated with complications, but the risk of rectovaginal fistula is higher if a disc excision or segmental colorectal resection is performed. It is therefore of utmost importance to evaluate preoperatively the bowel infiltration by several imaging techniques to estimate the feasibility of a deep rectal shaving with possible incomplete removal of the endometriotic lesions or to discuss with the patient about the indication of a segmental bowel resection. Because of the risk of major preoperative and postoperative complications, proper patient counseling is mandatory.

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Condition tags

endometriosis

MeSH descriptors

Digestive System Surgical Procedures Endometriosis Endometriosis Laparoscopy Rectal Diseases Rectal Diseases Female Humans Postoperative Complications Rectovaginal Fistula Rectovaginal Fistula Rectum Treatment Outcome

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References (45)

Cited by (16)

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