Calitatea vieţii la pacientele cu endometrioză şi rezecţie colorectală laparoscopică

Objective. The aim of this paper is to evaluate the effective­ness of laparoscopic colorectal resection in cases of deep en­do­metriosis, as well as the impact on the quality of life, on gynecological and digestive symptoms. Materials and method. Following the preoperative evaluation (MRI, trans­va­gi­nal ultrasound, endorectal ultrasound, hydro-colon CT), 42 cases with deep endometriosis were included in the studied group. All patients included in the study com­ple­ted a questionnaire on preoperative endometriosis symp­toms and quality of life (SF-36 Questionnaire). The status and qua­lity of life were assessed. Gynecological and di­ges­tive symp­toms, as well as the rate of perioperative com­pli­ca­tions were also assessed. Laparoscopic surgeries were per­formed by the same operating team (E.B., C.C.B., R.M., A.I., L.R.). Results. The average age of the patients was 34 years old. The conversion rate to laparotomy was zero. Fol­lowing surgery, there was a significant improvement re­gar­ding dysmenorrhea, dyspareunia, chronic pelvic pain, defe­ca­tion pain, and lower abdominal pain. In cases with deep endometriosis and colorectal resection, an im­prove­ment in the score for the quality of life, assessed by the SF-36 Questionnaire, was observed. One patient (2.38%) refused the colorectal resection for objective reasons. The rate of perioperative complications was 4.76%, including an inadvertent cystotomy (2.38%) and a reintervention (2.38%) at five days postoperatively – protective ileo­sto­my. The rate of hemoperitoneum, rectovaginal fistula, uro­pe­ri­to­neum and pelvic abscess was zero. Conclusions. La­pa­roscopic segmental colorectal resection for endome­trio­sis significantly improves the quality of life and the gy­ne­co­lo­gical and digestive symptoms. However, women should be informed about the risk of complications, in­clu­ding rec­to­va­ginal fistula. The need to adhere to a guide­line on the therapeutic conduct in cases of deep en­do­me­trio­sis and the standardization of treatment allow to obtain sa­tis­fac­tory results in terms of improving the quality of life in patients with colorectal resection. Preoperative investigations allow the planning of surgery and the formation of a multi­dis­ci­pli­nary team for the correct management and the complete ex­ci­sion of endometriotic lesions.