Synthèse des stratégies et prise en charge chirurgicale de l’endométriose, RPC Endométriose CNGOF-HAS

Horace Roman, Roman H, H. Roman, Ballester M, Marcos Ballester, M Ballester, Loriau J, J. Loriau, M Canis, Michel Canis, Bolze PA, Pierre‐Adrien Bolze, P A Bolze, Niro J, J. Niro, Stéphane Ploteau, S Ploteau, Ploteau S, Chrystèle Rubod, C. Rubod, Rubod C, Chadi Yazbeck, C Yazbeck, Collinet P, Pierre Collinet, P Collinet, Rabischong B, B. Rabischong, Merlot B, B Merlot, Benjamin Merlot, Xavier Fritel, X Fritel
Gynecologie, obstetrique, fertilite & senologie · 2018 · vol. 46(3) , pp. 326–330 · doi:10.1016/j.gofs.2018.02.020 · PMID:29526793 · W2790407213
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This paper reviews surgical strategies and management approaches for endometriosis, based on the CNGOF-HAS clinical practice guidelines.

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Abstract

The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser. Ablation of ovarian endometriomas using bipolar current is not recommended (B). Surgery may be employed in patients with deep endometriosis infiltrating the colon and the rectum, with good impact on painful complaints and postoperative conception. In these patients, laparoscopic route increases the likelihood of postoperative spontaneous conception when compared to open route. When compared to conservative rectal procedures (shaving or disc excision), segmental colorectal resection increases the risk of postoperative stenosis, requiring additional endoscopic or surgical procedures. In large deep endometriosis infiltrating the rectum (>20mm length of bowel infiltration), conservative rectal procedures do not improve postoperative digestive function when compared to segmental resection. In patients with bowel anastomosis, placing anti-adhesion agents on contact with bowel suture is not recommended, due to higher risk of bowel fistula (C). Various other recommendations are proposed in the text, however, they are based on studies with low level of evidence.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Adult Colonic Diseases Colonic Diseases Colonic Diseases Cystectomy Endometriosis Endometriosis Female Humans Hysterectomy Laparoscopy Rectal Diseases Rectal Diseases Rectal Diseases Urologic Diseases Urologic Diseases Urologic Diseases

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.

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Cited by (8)

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