Laparoscopic Treatment of Retrovaginal Septum Endometriosis

Ke Ma; Hongwu Wen

doi:10.3877/cma.j.issn.1673-5250.2011.05.003

Laparoscopic Treatment of Retrovaginal Septum Endometriosis

Ke Ma, Hongwu Wen

In: Chung-Hua Fu Ch'an K'o Tsa Chih · 2011 · vol. 7(5) , pp. 416–419 · doi:10.3877/cma.j.issn.1673-5250.2011.05.003 · W3032259873

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Laparoscopic excision of retrovaginal septum endometriosis in 12 cases demonstrated feasibility and effectiveness in relieving pain symptoms, with one case of rectal muscular injury.

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This retrospective study evaluated the feasibility and efficacy of laparoscopic excision for retrovaginal septum endometriosis by comparing outcomes in twelve patients undergoing laparoscopy versus five treated via open or vaginal approaches. The results indicated that while laparoscopic surgery required longer operative times, it resulted in significantly less blood loss compared to the abdominal/vaginal group, with most patients experiencing significant relief from pelvic pain symptoms. The authors noted a complication involving rectal muscular injury in one case and emphasized that the treatment should be performed by experienced surgeons due to the technical demands of the procedure. This paper is centrally about endometriosis — specifically the surgical management of deep infiltrating lesions located in the retrovaginal septum.

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Abstract

Objective To evaluate the feasibility and efficacy of laparoscopic excision of retrovaginal septum endometriosis. Methods A total of seventeen cases with retrovaginal septum endometriosis were included in this retrospective study between May 1995 and December 2010. Five cases were received abdominal or vaginal operations (abdominal/vaginal group) and twelve cases were received laparoscopic operations (laparoscopic group). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Peking University First Hospital. Informed consent was obtained from all participants. Results In the abdominal/vaginal surgery group, the mean operation time was 105 min (25 min to 276 min), and the mean blood loss volume was 464 mL (50 mL to 2000 mL). After operation, the pelvic pain was relieved in 4 cases, the sexual intercourse pain recurred in 1 case, rectal irritation symptom was partly relieved in lease. Whereas, in laparoscopy group, the mean operation time was 188 min (70 min to 360 min), and the mean blood loss volume was 153 mL (20 mL to 1500 mL). Rectal muscular injury happened in one case. After operation, the pelvic pain was relieved in 8 cases (partly relieved in 2 cases), the rectal irritation symptom was partly relieved in 4 cases. A successful pregnancy after the nine months of trying the operation. Conclusion Laparoscopic excision of retrovaginal septum endometriosis was feasible and can effectively relieve pain symptom. However, large randomized controlled studies would be required to validate this approach. Key words: retrovaginal septum endometriosis; laparoscopic surgery

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Objective

To evaluate the feasibility and efficacy of laparoscopic excision of retrovaginal septum endometriosis.

Methods

A total of seventeen cases with retrovaginal septum endometriosis were included in this retrospective study between May 1995 and December 2010. Five cases were received abdominal or vaginal operations (abdominal/vaginal group) and twelve cases were received laparoscopic operations (laparoscopic group). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Peking University First Hospital. Informed consent was obtained from all participants.

Results

In the abdominal/vaginal surgery group, the mean operation time was 105 min (25 min to 276 min), and the mean blood loss volume was 464 mL (50 mL to 2000 mL). After operation, the pelvic pain was relieved in 4 cases, the sexual intercourse pain recurred in 1 case, rectal irritation symptom was partly relieved in lease. Whereas, in laparoscopy group, the mean operation time was 188 min (70 min to 360 min), and the mean blood loss volume was 153 mL (20 mL to 1500 mL). Rectal muscular injury happened in one case. After operation, the pelvic pain was relieved in 8 cases (partly relieved in 2 cases), the rectal irritation symptom was partly relieved in 4 cases. A successful pregnancy after the nine months of trying the operation.

Conclusion

Laparoscopic excision of retrovaginal septum endometriosis was feasible and can effectively relieve pain symptom. However, large randomized controlled studies would be required to validate this approach. | 1 Leng JH. Diagnosis progress of deep infiltrating endometriosis [J]. Chin J Pract Obstet Gynecol, 2008, 24 (1): 12-15.[冷金花.深部浸润型子宫内膜异位症的诊治进展[J].中国实用妇科与产科杂志，2008,24 (1)：12-15.] | | | 2 Qie MR. Treatment progress of endometrisis [J/CD]. Chin J Obstet Gynecol Pediatr (Electron Ed), 2008,4(4): 288-293.[郄明蓉.子宫内膜异位症的治疗现状及进展[J/CD].中华妇幼临床医学杂志:电子版，2008，4 (4)：288-293.] | | | 3 Dennez J, Langendonckt AV, Casanas-Roux F, et al. Current thinking on the pathogenesis of endometriosis [J]. Gynecol Obstet Invest, 2002, 54(suppl 1): 52-62. | | | 4 Koninckx PR, Meuleman C, Oosterlynck D, et al. Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA125 concentration [J]. Fertil Steril, 2001, 75: 1042-1044. | | | 5 Chapron C, Jacob S, Dubuisson JB, et al. Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum [J]. Acta Obstet Gynecol Scand, 2001, 80: 349-354. | | | 6 Vercellini P, Carmignani L, Rubino T, et al. Surgery for deep endometriosis: A pathogenesis-oriented approach [ J]. Gynecol Obstet Invest, 2009, 68: 88-103. | | | 7 Donnez J, Nisolle M, Gillerot S, et al. Rectovaginal septum adenomyotic nodules: A series of 500 cases [J]. Br J Obstet Gynecol, 1997, 104: 1014-1018. | | [1] | 池畔, 黄胜辉. 中国腹腔镜直肠癌根治术30年来的巨大进步[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 596-600. | | [2] | 任传富, 杨志, 徐恩, 何梓芸, 罗板鑫, 陈新, 夏雪峰. 腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝合并胃食管反流病40 例临床分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 507-511. | | [3] | 刘明昊, 李晨, 王冰, 万政, 田文. 机器人与腹腔镜食管裂孔疝修补术对比研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 376-382. | | [4] | 张蕾, 彭超, 周应芳. 直肠阴道隔子宫内膜异位症腹腔镜手术技巧[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 257-261. | | [5] | 徐敬云, 丁波, 蒋宇慧, 沈杨. 妊娠期单孔腹腔镜手术实施行与思[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 262-266. | | [6] | 李干斌, 侯睿, 郭雅萍, 张潇, 邱小原, 牛备战, 林国乐. 改良经辅助切口回肠造口在腹腔镜直肠癌根治术的应用[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 271-276. | | [7] | 中国研究型医院学会微创外科学专业委员会. 单孔腹腔镜胆囊切除术中国专家共识(2024版)[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(04): 193-198. | | [8] | 刘庭秀, 刘新敏, 刘莹, 隋娟, 武宇, 赵瑜敬, 毕红, 孙雪梅, 范秀华. 腹壁整形术后腹腔镜新脐入路治疗卵巢肿物的安全性探讨[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 189-192. | | [9] | 李维坤, 邵欣欣, 胡海涛, 卢一鸣, 王鹏, 杜永星, 徐泉, 田艳涛. 腹腔镜胃间质瘤手术切除策略分析[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 141-145. | | [10] | 王酉, 严斌, 狄文, 楼微华. 经脐单孔腹腔镜前哨淋巴结活检术在早期子宫内膜癌手术中的探讨[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 173-176. | | [11] | 张宗明, 董家鸿, 何小东, 王秋生, 徐智, 刘立民, 张翀. 老年胆道外科热点问题的争议与思考[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 754-762. | | [12] | 张迪, 王春霞, 张学东, 李发馨, 庞淅文, 陈一锋, 张维胜, 王涛. 梗阻性左半结直肠癌自膨式金属支架置入后行腹腔镜手术与开腹手术的短期临床疗效比较[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 375-380. | | [13] | 孙鹏, 陈瑛罡. 腹部无辅助切口经肛门取标本的腹腔镜下直肠癌根治术一例（附视频）[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(04): 347-352. | | [14] | 吕东, 朱盛, 胡秋平, 徐如祥. 腹腔镜下直肠癌手术并发颅内静脉窦血栓一例报道[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(04): 250-253. | | [15] | 曹猛, 郭杰东, 朱灿, 许腾, 樊瑞智, 江涛, 宋军, 徐溢新. 完全腹腔镜右半结肠切除术中顺蠕动侧侧吻合的有效性及安全性评价[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 315-319. | | 阅读次数 | ||||| | 全文 | | |||| | 摘要 | | |||| 版权所有中华医学会中华医学电子音像出版社有限责任公司京ICP备14006079号-1 网络出版服务许可证：(署)网出证(京)字第075号 AI 小编 AI小编

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