Moyens de prévention des complications anastomotiques digestives dans la chirurgie de l’endométriose profonde, RPC Endométriose CNGOF-HAS

Loriau J, J. Loriau, E Petit, Petit E, Mephon A, A. Méphon, A Mephon, Benjamin Angliviel, Angliviel B, B Angliviel, Sauvanet E, Éric Sauvanet, E. Sauvanet
Gynecologie, obstetrique, fertilite & senologie · 2018 · vol. 46(3) , pp. 296–300 · doi:10.1016/j.gofs.2018.02.007 · PMID:29525185 · W2793841512
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This paper reviews methods to prevent digestive anastomotic complications in deep endometriosis surgery.

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Abstract

Management of deep pelvic and digestive endometriosis can lead to colorectal resection and anastomosis. Colorectal anastomosis carries risks for dreaded infectious and functional morbidity. The aim of the study was to establish, regarding the published data, the role of the three most common used surgical techniques to prevent such complications: pelvic drainage, diverting stoma, epiplooplasty. Even if many studies and articles have focused on colorectal anastomotic leakage prevention in rectal cancer surgery data regarding this topic in the setting of endometriosis where lacking. Due to major differences between the two situations, patients, diseases the use of the conclusions from the literature have to be taken with caution. In 4 randomized controlled trials the usefulness of systematic postoperative pelvic drainage hasn't been demonstrated. As this practice is not systematically recommended in cancer surgery, its interest is not demonstrated after colorectal resection for endometriosis. There is a heavy existing literature supporting systematic diverting stoma creation after low colorectal anastomosis for rectal cancer. Keeping in mind the important differences between the two situations, the conclusions cannot be directly extrapolated. In endometriosis surgery after low rectal resection, stoma creation must be discussed and the patient must be informed and educated about this possibility. Even if widely used there is no data supporting the role of epiplooplasty in colorectal anastomotic complication prevention? The place for epiplooplasty in preventing rectovaginal fistula occurrence in case of concomitant resection hasn't been studied.

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Condition tags

endometriosis

MeSH descriptors

Anastomosis, Surgical Anastomosis, Surgical Colonic Diseases Endometriosis Rectal Diseases Colon Colon Colonic Diseases Colonic Diseases Drainage Endometriosis Endometriosis Female Humans Omentum Omentum Postoperative Care Postoperative Complications Postoperative Complications Rectal Diseases

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.

References (60)

Cited by (8)

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License: CC0 · commercial use OK