Surgery for gastrointestinal endometriosis: indications and results

Houtmeyers P, Philippe Houtmeyers, P Houtmeyers, Wim Ceelen, W Ceelen, J. M. Gillardin, Gillardin JM, Dhondt M, Mathieu D’Hondt, M Dhondt, P Pattyn, Piet Pattyn, Pattyn P
Acta chirurgica Belgica · 2006 · vol. 106(4) , pp. 413–416 · doi:10.1080/00015458.2006.11679918 · PMID:17017695 · W172746127
Other OA: closed CC0 ⤵ 21 in-corpus citations
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This study reports on 13 patients with gastrointestinal endometriosis, finding that surgical removal of lesions achieved symptom relief in 83.3% and a 66.6% pregnancy rate, despite imperfect preoperative diagnosis.

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Abstract

BACKGROUND: Although gastrointestinal endometriosis is an uncommon and often unexpected finding, the best treatment requires removal of all endometriotic lesions. The purpose of our study was to report our experience with the diagnosis and treatment of bowel endometriosis. MATERIAL AND METHODS: From January 1997 to January 2004, 13 patients (mean 35.7y ; range 21-55y) were operated for bowel endometriosis. We noted: age, history of endometriosis, previous pregnancies, preoperative investigations and symptoms, operative procedure and intraoperative findings. Follow-up varied between one month postoperative examination and seven years. RESULTS: Presenting symptoms of the cases were: acute appendicitis (3), dysmenorrhoea (7), constipation (6), pelvic pain (2), rectal bleeding (3) and dyspareunia (2). Operative management was performed in accordance with the anatomical distribution. Seven patients had a history of previous operations and multifocal involvement was present in 61.5% of cases. At a median follow-up of 12.2 months, 83.3% had complete relief of their initial complaints, with only one reoperation needed. The pregnancy rate after surgery was 66.6%. Preoperative tests were: ultrasound for ovarian endometriomas, coloscopy, barium enema, vaginal palpation for detecting rectovaginal involvement, MRI and CT scan. These tests predicted the extension of endometriotic process correctly in 50% of the cases. CONCLUSIONS: Endometriosis of the sigmoid and rectum is rare but can give rise to severe gastrointestinal and pelvic symptoms. Preoperative investigations are not infallible in predicting the extent of the disease, sometimes placing the surgeon before a dilemma, because it involves mostly young women in the reproductive phase of life. The colorectal surgeon, therefore, should seek the advice of an experienced gynaecologist and vice versa. Removal of all endometriotic lesions is mandatory for obtaining an optimal relief of symptoms.

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Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_painbowel_endometriosis

MeSH descriptors

Endometriosis Intestinal Diseases Adult Adult Age Factors Age Factors Appendicitis Appendicitis Appendicitis Colonoscopy Colonoscopy Constipation Constipation Constipation Dysmenorrhea Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Dyspareunia

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (22)

Cited by (20)

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