Eine neue Operationsmethode zur Therapie der rektovaginalen Endometriose auf der Basis histologischer Befunde

The study evaluated a newly described combined vaginal–laparoscopic–abdominal surgical method in 20 patients suspected of rectovaginal, septum rectovaginale/darminfiltrating endometriosis, using preoperative vaginal sonography, rectal endosonography, sigmoidoscopy, and MRI; the diagnosis was then corroborated by histology of resected tissue. All patients underwent rectosigmoid resection, with additional procedures in some cases (appendectomy, cecal resection, and further sigmoid resection) due to multifocal disease, and postoperative outcomes were generally uncomplicated aside from an enteral Clostridia infection and a conservatively managed subileus. The authors report that preoperative tests had limited sensitivities (35%, 33%, 50%, and 5% respectively), while histology confirmed bowel wall infiltration in all 20 patients, supporting the operative approach despite diagnostic limitations. This paper is centrally about endometriosis — specifically rectovaginal and bowel-infiltrating rectovaginal endometriosis treated with a histology-guided combined surgical technique.

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