Double Circular Stapler Technique for Bowel Resection in Rectosigmoid Endometriosis

Oliveira MA, Marco Aurélio Pinho Oliveira, Marco Aurelio Pinho Oliveira, Claudio P Crispi, Claudio Peixoto Crispi, Crispi CP, Flavio M Oliveira, Oliveira FM, Flávio Malcher Martins de Oliveira, Salomão Paulo, Paulo S Junior, Junior PS, Thiers S Raymundo, Raymundo TS, Thiers Soares Raymundo, Thiago D Pereira, Pereira TD, T.D. Pereira
Journal of minimally invasive gynecology · 2013 · vol. 21(1) , pp. 136–141 · doi:10.1016/j.jmig.2013.07.022 · PMID:23969140 · W1980706297
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This paper describes a double circular stapler technique for bowel resection in rectosigmoid endometriosis, aiming to improve surgical outcomes.

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Abstract

To reduce bladder function impairment and avert the serious complications of anastomotic leakage after segmental rectosigmoidectomy and to minimize the persistence of endometriotic lesions associated with discoid resection, we used the double circular stapling (DCS) technique. This technique enables excision of bowel endometriosis nodules larger than those that can be removed with the single-load technique of the circular stapler. Of 120 patients who underwent surgery to treat bowel endometriosis, intestinal shaving was performed in 24, discoid resection with single circular stapling in 40, and rectosigmoidectomy in 55. Eleven patients (9.2%) underwent the DCS technique. In the DCS group, the size of the rectosigmoid lesion ranged from 2.2 cm to 4.2 cm. Median operative time for the DCS technique was 100 minutes, compared with 150 minutes for rectosigmoidectomy (p = .04). Only 1 of 11 patients (9%) had urinary retention, compared with postoperative urinary retention in 14 of 55 patients (25%) who had undergone rectosigmoidectomy (difference not significant). Only 1 patient, with a 4.2-cm nodule, had a positive margin in the specimen obtained at the second stapling. DCS is a promising technique and may avert rectosigmoidectomy in selected patients.

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Condition tags

endometriosis

MeSH descriptors

Anastomosis, Surgical Endometriosis Intestinal Diseases Intestine, Large Laparoscopy Adult Anastomosis, Surgical Endometriosis Female Humans Intestinal Diseases Intestine, Large Laparoscopy Middle Aged Retrospective Studies 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.

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Cited by (27)

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