Laparoscopic treatment of deep endometriosis with segmental colorectal resection: Short-term morbidity

Liliana Mereu, Giacomo Ruffo, Ruffo G, Landi S, Stefano Landi, F Barbieri, Fabrizio Barbieri, Barbieri F, Zaccoletti R, Riccardo Zaccoletti, Fiaccavento A, Andrea Fiaccavento, Anna Stepniewska, Ania Stepniewska, Pontrelli G, Giovanni Pontrelli, Minelli L, Luca Minelli
Journal of Minimally Invasive Gynecology · 2007 · vol. 14(4) , pp. 463–469 · doi:10.1016/j.jmig.2007.02.008 · PMID:17630164 · W2084119760
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This study evaluated the short-term morbidity associated with laparoscopic segmental colorectal resection for treating deep endometriosis.

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Abstract

Study objectiveAdequate surgical treatment of severe deep endometriosis requires complete excision of all implants, but the modality of bowel resection is still debated. We describe the results of our experience as a tertiary care endometriosis referral center in complete laparoscopic management of deep pelvic endometriosis with bowel involvement.DesignA prospective single-center study (Canadian Task Force classification II-1).SettingIn Sacro Cuore General Hospital of Negrar, Italy.PatientsOne hundred ninety-two women treated with laparoscopic excision of deep endometriosis and segmental colorectal resections were evaluated.InterventionFrom January 2003 through December 2005 we registered all consecutive patients laparoscopically treated for deep endometriosis who also were having segmental bowel resection.Measurements and main resultsData analysis included age, weight, body mass index, history of endometriosis, preoperative symptoms, parity, infertility, operative procedures, operating time, conversion, intraoperative and postoperative morbidity, recovery of bladder and bowel function, and discharge from hospital. We report our results in terms of feasibility and short-term morbidity. Radicality was achieved in 91.5% of patients. Laparoconversion occurred in 5 cases (2.6%). Major complications that required repeat operation occurred in 20 cases (10.4%): Nine anastomosis leakages (4.7%), 3 uroperitoneum (1.6%), 4 hemoperitoneum (2.1%), 1 pelvic abscess (0.5%), 1 bowel perforation, 1 intestinal obstruction, and 1 sepsis. Minor complications occurred in 50 patients (26%).ConclusionLaparoscopic segmental colorectal resection for endometriosis is feasible and, in hospitals with necessary experience, can be proposed to selected patients who are informed of the risk of complications.

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endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Sigmoid Diseases Adult Colectomy Colectomy Endometriosis Endometriosis Feasibility Studies Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Italy Laparoscopy Laparoscopy Morbidity Prospective Studies Rectal Diseases Rectal Diseases

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