Histopathologic analysis of intestinal endometriosis after laparoscopic low anterior resection

Makoto Jinushi, Jinushi M, Atsushi Arakawa, Arakawa A, Toshiharu Matsumoto, Matsumoto T, Kumakiri J, Jun Kumakiri, Kitade M, Mari Kitade, Iwaho Kikuchi, Sakamoto K, Kazuhiro Sakamoto, Satoru Takeda
Journal of Minimally Invasive Gynecology · 2010 · vol. 18(1) , pp. 48–53 · doi:10.1016/j.jmig.2010.08.696 · PMID:20934921 · W2034505540
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This study presents a histopathologic analysis of intestinal endometriosis following laparoscopic low anterior resection, focusing on surgical outcomes and tissue characteristics.

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Abstract

STUDY OBJECTIVE: To determine how intestinal endometriosis spreads, and, thus, to improve outcomes of curative surgery. DESIGN: Descriptive study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: Ten patients who underwent laparoscopic low anterior resection of intestinal endometriosis at our hospital between January 1999 and August 2007. INTERVENTION: Laparoscopic low anterior resection of intestinal endometriosis. MEASUREMENTS AND MAIN RESULTS: Mapping of endometriotic foci, degree of vertical infiltration to the intestinal layers, and longitudinal spread of endometriotic foci to the intestinal plane were defined using hematoxylin-eosin, estrogen receptor, progesterone receptor, and CD10 staining. RESULTS: Endometriotic foci tended to spread concentrically around a primary lesion that comprised most of a resected specimen. The deepest layer containing endometriotic foci at the primary lesion was the submucosal layer in 7 specimens (70%), and the internal circular muscle layer in 3 (30%). Satellite lesions comprising thickened areas that were independent of the primary lesion were detected in 5 specimens (50%). Multiple endometriotic foci were confirmed in all satellite lesions. CONCLUSIONS: Endometriotic foci might not only infiltrate the primary lesion in intestinal endometriosis but also disseminate to other areas. Thus, the primary lesion of intestinal endometriosis with a large margin must be excised via low anterior resection.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Intestinal Diseases Intestinal Diseases Adult Adult Endometriosis Endometriosis Female Female Humans Humans Intestinal Diseases Intestinal Diseases Laparoscopy Laparoscopy Treatment Outcome Treatment Outcome

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