Résection rectale segmentaire et shaving rectal laparoscopiques pour endométriose : morbidité péri-opératoire

B Canon, Bradley Canon, Canon B, Pierre Collinet, Collinet P, P Collinet, G Piessen, Guillaume Piessen, Piessen G, Chrystèle Rubod, Rubod C, C. Rubod
Gynecologie, obstetrique & fertilite · 2013 · vol. 41(5) , pp. 275–281 · doi:10.1016/j.gyobfe.2013.02.005 · PMID:23660479 · W1981864555
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This study investigated the peri-operative morbidity associated with laparoscopic segmental rectal resection and rectal shaving for endometriosis.

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Abstract

ObjectiveA comparative study of the peri-operative complications between two surgical methods used in the treatment of bowel endometriosis: shaving versus segmentary colorectal resection.Patients and methodsForty-one patients, who were treated by laparoscopic treatment of bowel endometriosis between January, 2010 and November, 2011 were included in a retrospective, unicenter series. Twenty patients had a "shaving" while 21 had a segmentary rectal resection.ResultsThe average follow-up was of 13.6±6.7 months. No recurrence was observed during the study. The duration of surgery and the length of stay were significantly longer in the resection group, respectively 485.5±85min and 9.6±6.5 days against 259.3±104min and 4±1.3 days in the shaving group. The rates of early and late complications (Dindo classification) were respectively 71.4% and 33.3% in the resection group against 20% and 0% in the shaving group (P<0.05). Our rate of vaginal fistula was null; this is to put in connection with the fact that an ileostomy of discharge was realized in 95.2% of the resections, as well as an epiplooplasty, when it was technically possible, in the case of a concomitant vaginal opening.Discussion and conclusionThe peri-operative morbidity was higher after partial bowel resection. Our study underlines that these two techniques are probably not addressed to the same patients. Considering the significant morbidity, it would be interesting to define in a consensual way, who the surgery should be propose to and by which procedure.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Intestinal Diseases Laparoscopy Postoperative Complications Rectum Adult Endometriosis Female Humans Intestinal Diseases Laparoscopy Length of Stay Middle Aged Postoperative Complications Rectum Recurrence Retrospective Studies Treatment Outcome

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