Impact of laparoscopic colorectal segment resection on quality of life in women with deep endometriosis: one year follow-up

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This study evaluated quality of life changes in 40 women one year after laparoscopic colorectal resection for deep endometriosis, finding significant improvements in all SF-36 domains.

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This prospective observational cohort study evaluated changes in quality of life over 1 year in 40 women with intestinal deep endometriosis who underwent laparoscopic colorectal segment resection, with preoperative pelvic MRI and rectal echoendoscopy confirming intestinal involvement. Quality of life was measured using the SF-36 at baseline (T0), 6 months (T1), and 1 year (T2), and significant improvements were reported across all SF-36 domains over time (p < 0.05), with the largest median gains in physical functioning and role-related subscales; pain and general health showed comparatively smaller median changes. The authors found no differences in QOL improvement by age, parity, or body mass index, and noted that those with the poorest initial QOL scores had the greatest improvements by the end point. The paper relates to endometriosis by directly assessing postoperative one-year QOL after laparoscopic colorectal segment resection specifically for deep endometriosis with bowel involvement.

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Abstract

PurposeTo evaluate the changes in quality of life (QOL) over a 1-year follow-up period in patients submitted to laparoscopic colorectal resection for the treatment of deep endometriosis.MethodsA prospective observational cohort study (Canadian Task Force Design Classification II) involving 40 women with intestinal deep endometriosis was conducted between June 2007 and September 2008 at the Department of Obstetrics and Gynecology, Santa Casa Medical School, Sao Paulo, Brazil. Prior to the surgical procedure, all patients received magnetic resonance studies of the pelvis and rectal echoendoscopy, which suggested intestinal involvement of the disease in all cases. The patients received laparoscopic colorectal resections and treatment for other endometriotic lesions. The subjects completed the QOL SF-36 at 3 time points (T0 pre-operatively; T1 6 months post-operatively; and T2 1 year post-operatively).ResultsThe physical functioning, role physical, social functioning and role emotional subscales evidenced the most substantial median increases for T0, T1 and T2. The pain, general health, vitality and mental health domains showed slight changes and increases in medians but did not increase to the same extent as the previous group. Significant improvements were observed in all domains of the SF-36 throughout the study period (p < 0.05). Physical health-related QOL domains showed greater improvement than mental health domains. Analyses of age, parity and body mass index as potential factors influencing the impact of surgery on QOL revealed no differences. Therefore, these factors were not used as prognostic indicators for the surgical procedure or for patient follow-up. In addition, we noted that the patients with poorest results on the initial QOL questionnaire showed the greatest improvements at the end point.ConclusionThe study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.
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Abstract

Purpose To evaluate the changes in quality of life (QOL) over a 1-year follow-up period in patients submitted to laparoscopic colorectal resection for the treatment of deep endometriosis.

Methods

A prospective observational cohort study (Canadian Task Force Design Classification II) involving 40 women with intestinal deep endometriosis was conducted between June 2007 and September 2008 at the Department of Obstetrics and Gynecology, Santa Casa Medical School, Sao Paulo, Brazil. Prior to the surgical procedure, all patients received magnetic resonance studies of the pelvis and rectal echoendoscopy, which suggested intestinal involvement of the disease in all cases. The patients received laparoscopic colorectal resections and treatment for other endometriotic lesions. The subjects completed the QOL SF-36 at 3 time points (T0 pre-operatively; T1 6 months post-operatively; and T2 1 year post-operatively).

Results

The physical functioning, role physical, social functioning and role emotional subscales evidenced the most substantial median increases for T0, T1 and T2. The pain, general health, vitality and mental health domains showed slight changes and increases in medians but did not increase to the same extent as the previous group. Significant improvements were observed in all domains of the SF-36 throughout the study period (p < 0.05). Physical health-related QOL domains showed greater improvement than mental health domains. Analyses of age, parity and body mass index as potential factors influencing the impact of surgery on QOL revealed no differences. Therefore, these factors were not used as prognostic indicators for the surgical procedure or for patient follow-up. In addition, we noted that the patients with poorest results on the initial QOL questionnaire showed the greatest improvements at the end point.

Conclusion

The study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.

References

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Rights and permissions About this article Cite this article Ribeiro, P.A.A., Sekula, V.G., Abdalla-Ribeiro, H.S. et al. Impact of laparoscopic colorectal segment resection on quality of life in women with deep endometriosis: one year follow-up. Qual Life Res 23, 639–643 (2014). https://doi.org/10.1007/s11136-013-0481-y Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s11136-013-0481-y

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endometriosis

MeSH descriptors

Colectomy Endometriosis Endometriosis Laparoscopy Quality of Life Adult Brazil Cohort Studies Colectomy Endometriosis Female Follow-Up Studies Humans Laparoscopy Prospective Studies Quality of Life Surveys and Questionnaires Treatment Outcome

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