Apport du couple IRM-coloscanner pré-opératoire dans la planification chirurgicale de l’endométriose digestive

de Lapparent C, C. de Lapparent, Verpillat P, P. Verpillat, A Gandon, Anne Gandon, Gandon A, Éric Kamus, Kamus E, E Kamus, Fourquet T, T. Fourquet, Anne-Sophie Jacques, A-S Jacques, Jacques AS, C. Capelle, Capelle C, Collinet P, Pierre Collinet, P Collinet, Chrystèle Rubod, C. Rubod, Rubod C, Puech P, P. Puech
Gynecologie, obstetrique, fertilite & senologie · 2021 · vol. 49(12) , pp. 913–922 · doi:10.1016/j.gofs.2021.02.008 · PMID:33639282 · W3132437183
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Preoperative MRI and CT colonography were used to assess the digestive endometriotic lesions and aid in surgical planning for patients undergoing resection.

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Abstract

IntroductionThe digestive involvement of endometriosis accounts for up to 20-25% of deep localisations. Precise mapping of digestive lesions is essential in order to plan surgery and specialized teams. The aim of this study is to assess the contribution of the MRI-coloscan couple in the preoperative assessment of digestive endometriosis.MethodsWe analyzed 45 files of patients referred for suspected digestive endometriosis. They had all undergone a preoperative MRI and coloscan associated with surgery throughout the year. We first compared the data collected in imaging, and then compared the synthesis of this data with the surgical procedure performed.Results35 patients required digestive surgery. 24 of 45 files were concordant in MRI and coloscanner. Data from MRI alone matched with surgery in 69% of cases, against 84% for the coloscan. The synthesis allowed a concordance of 89%. 25 segmental resections, 2 discoid and 16 shaving were performed. The use of coloscan made up for nine extra cases: the detection of four additional cases of multifocality, a single undiagnosed case of a deep lesion, and allowed to specify the depth of the involvement in four cases. On the contrary, the MRI was correct compared to the CT in four cases. The presence of a digestive surgeon was necessary in 53% of cases.ConclusionIn the era of imaging staging, it would seem interesting to turn towards a subclassification of the digestive involvement of endometriosis in order to decide which surgery to perform. In our experience, the coloscan is a useful complement of MR, especially to assess the depth of involvement and the multifocality.

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Condition tags

endometriosis

MeSH descriptors

Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Endometriosis Endometriosis Laparoscopy Laparoscopy Surgeons Female Humans Magnetic Resonance Imaging Magnetic Resonance Imaging Pelvis Pelvis Pelvis

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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