Deeply infiltrating endometriosis affecting the rectum and lymph nodes

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This prospective study of 35 rectosigmoidectomy samples found that endometriosis affected lymph nodes in 54% of cases, especially when lesions were thick or extensively involved the intestinal circumference.

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Abstract

ObjectiveTo analyze morphologic aspects of bowel endometriosis.DesignProspective study of 35 consecutive cases of bowel endometriosis.SettingMultidisciplinary group practice and teaching hospital.Patient(s)Thirty-five patients with bowel endometriosis were assessed between September 2003 and June 2005.Intervention(s)Histologic analysis of 35 tissue samples removed at laparoscopic rectosigmoidectomy.Main outcome measure(s)We performed an evaluation of lesion size, number of lesions present in the bowel, intestinal wall layers affected by the endometriotic lesion, circumference of the intestinal loop affected by the endometriotic lesion, and presence of lymph nodes with foci of endometriosis.Result(s)Analysis of the surgical samples revealed lymph nodes in the pericolic adipose tissue of 19 (54%), cases and in 5 of these cases (26.3%), endometriosis had affected the lymph nodes. When the thickness of the endometriotic lesion reached 1.75 cm, lymph nodes of all patients were affected, and all patients in whom more than 80% of the circumference of the intestinal loop was affected by endometriosis presented with positive lymph nodes.Conclusion(s)This study raises doubts about whether this form of the disease can still be considered a clinically benign disease.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Lymphatic Diseases Lymph Nodes Rectal Diseases Rectum Adult Endometriosis Female Humans Lymphatic Diseases Lymph Nodes Middle Aged Rectal Diseases Rectum

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