Laparoscopic management of bowel endometriosis: resection margins as a predictor of recurrence

Konstantinos Nirgianakis, Brett McKinnon, Sara Imboden, Laura Knabben, Beat Gloor, Michael D Mueller
Acta obstetricia et gynecologica Scandinavica · 2014 · vol. 93(12) , pp. 1262–1267 · doi:10.1111/aogs.12490 · PMID:25175300 · W2126490047
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This study found that positive bowel resection margins, age under 31, and a BMI over 23 kg/m² independently predicted recurrence in women undergoing laparoscopic resection for bowel endometriosis.

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Abstract

OBJECTIVE: To evaluate possible predictive factors for recurrence after laparoscopic segmental bowel resection for bowel endometriosis. DESIGN: Cohort study. SETTING: Academic tertiary referral center. METHODS: 95 symptomatic women with bowel endometriosis who underwent laparoscopic segmental bowel resection at the Endometriosis clinic, University of Berne, between 2002 and 2012 were enrolled. Since 14 women were lost to follow-up, 81 formed the final cohort. Clinical and histological characteristics were examined as possible predictive factors for disease recurrence. MAIN OUTCOME MEASURES: Recurrence, defined as a subsequent operation due to recurrent endometriosis-associated pain with a histologically confirmed endometriotic lesion. RESULTS: Recurrence was observed in 13 (16%) patients. Variables that were significantly associated to recurrence by the Cox regression analysis were positive bowel resection margins (hazard ratio 6.5, 95% confidence interval 1.8-23.5, p = 0.005), age <31 years (hazard ratio 5.6, 95% confidence interval 1.7-18.6, p = 0.005) and body mass index ≥23 kg/m(2) (hazard ratio 11.0, 95% confidence interval 2.7-44.6, p = 0.001). CONCLUSIONS: Positive bowel resection margins as well as age <31 years and body mass index ≥23 kg/m(2) appear to be independent predictors of disease recurrence.

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Condition tags

mesh:D004715endometriosisbowel_endometriosis

MeSH descriptors

Colonic Diseases Endometriosis Laparoscopy Rectal Diseases Adult Age Factors Colonic Diseases Colonic Diseases Endometriosis Endometriosis Female Follow-Up Studies Humans Laparoscopy Middle Aged Norway Prognosis Quality of Life Rectal Diseases Rectal Diseases

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