Single Center Experience of a Safe and Feasible Segmental Resection of Rectosigmoid Endometriosis

Adianto Nugroho, Rofi Saunar, Indah Jamtani, M Luky Syahbana, Syamsu Hudaya, Aditomo Widarso, Taslim Poniman
In: Iranian Journal of Colorectal Research, Vol 8, Iss 4, Pp 187-191 (2020) · 2020 · doi:10.30476/acrr.2021.88432.1065 · W3120014545
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This single-center study evaluated segmental rectosigmoid resection in nine patients with deep infiltrating endometriosis, concluding the procedure is safe and feasible for comprehensive multidisciplinary management of bowel endometriosis.

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This single-center study evaluated the safety and feasibility of segmental resection for rectosigmoid endometriosis, analyzing nine patients who underwent this procedure alongside primary gynecological resections. The authors noted that deep infiltrating endometriosis affecting the bowel is relatively common within their cohort, with a significant portion involving infiltration beyond the rectal serosa, necessitating more extensive surgical intervention than disc excision or shaving. The findings indicate that segmental resection, including minimally invasive approaches, is a viable component of comprehensive multidisciplinary management for these complex cases. This paper is centrally about endometriosis — specifically the surgical management of deep infiltrating lesions in the rectosigmoid colon.

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Abstract

Bowel endometriosis, defined as presence of endometrial tissue infiltrating the intestinal muscularis propria layer and beyond (3), has a sigmoid colon and rectal predilection. We collected 170 cases of endometriosis within the timeline, out of which DIE was diagnosed in 47 cases (27%). Deep Infiltrating Endometriosis (DIE) that effected the bowel, including those that only effected the perirectal fat and rectal serosa were 19 cases (40%); 11 cases (58%) had DIE infiltrating past the rectal serosa. A total of 8 cases (42%), with only perirectal fat and rectal serosa involvement were treated with either disc excision or shaving, were excluded from this study We described the clinical characteristics of 9 patients with rectal DIE that were treated with Segmental Resection along with primary gynecological resection. In summary, Segmental resection is safe and feasible, even with minimally invasive technique, to be incorporated in the comprehensive multidisciplinary management of bowel endometriosis. Further effort to expand its use is necessary to increase the scope of bowel endometriosis management across the country.
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Abstract

Bowel endometriosis, defined as presence of endometrial tissue infiltrating the intestinal muscularis propria layer and beyond (3), has a sigmoid colon and rectal predilection. We collected 170 cases of endometriosis within the timeline, out of which DIE was diagnosed in 47 cases (27%). Deep Infiltrating Endometriosis (DIE) that effected the bowel, including those that only effected the perirectal fat and rectal serosa were 19 cases (40%); 11 cases (58%) had DIE infiltrating past the rectal serosa. A total of 8 cases (42%), with only perirectal fat and rectal serosa involvement were treated with either disc excision or shaving, were excluded from this study We described the clinical characteristics of 9 patients with rectal DIE that were treated with Segmental Resection along with primary gynecological resection. In summary, Segmental resection is safe and feasible, even with minimally invasive technique, to be incorporated in the comprehensive multidisciplinary management of bowel endometriosis. Further effort to expand its use is necessary to increase the scope of bowel endometriosis management across the country.

Keywords

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