Résection cœlioscopique du colon-rectum pour endométriose : résultats préliminaires

Marpeau O, O Marpeau, Olivier Marpeau, Thomassin I, Isabelle Thomassin, I THOMASSIN, Emmanuel Barranger, Barranger E, E Barranger, Romain Detchev, R Detchev, Detchev R, Bazot M, Marc Bazot, M Bazot, E. Daraï, Daraï E, Émile Daraï
Journal de gynecologie, obstetrique et biologie de la reproduction · 2004 · vol. 33(7) , pp. 600–606 · doi:10.1016/s0368-2315(04)96600-8 · PMID:15550878 · W2043662446
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Laparoscopic colectomy for rectal endometriosis offers preliminary positive outcomes in bowel function and quality of life for affected patients.

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Abstract

ObjectiveColorectal endometriosis is source of chronic pelvic pain greatly affecting quality-of-life. Colorectal resection is indicated after failure of medical treatment. Few data are available on complications and functional results after laparoscopic colorectal resection for endometriosis. Therefore, the aims of this prospective study were to evaluate the feasibility, peri-operative complications and functional results of laparoscopic colorectal resection for endometriosis.Materials and methodsFrom March 2001 to March 2003, 32 consecutive women with clinically-suspected colorectal endometriosis confirmed by MR imaging and rectal endoscopic sonography were included in this prospective study.ResultsConversion to open surgery was required for four of the 32 women (12.5%). Mean operating time was 6 hours (range 4 to 13). Associated surgical procedures were: adhesiolysis (n=24), ureteral lysis (n=19), ovarian cystectomy (n=11), and hysterectomy (n=4). Mean blood loss was 2.4 g/dl (range: 0 to 8.6). Blood transfusion was required in 6 women including two who underwent laparoconversion. Two rectovaginal fistulae (6.3%) occurred requiring a colostomy. Urinary retention was noted in 6 women (15.6%).ConclusionLaparoscopic colorectal resection for endometriosis is feasible and is associated with a significant improvement of symptoms. However, the benefit of this procedure has to be weighed against the high morbidity.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Colonic Diseases Colorectal Surgery Endometriosis Laparoscopy Rectal Diseases Adult Blood Transfusion Colonic Diseases Colorectal Surgery Colorectal Surgery Endometriosis Female Humans Hysterectomy Laparoscopy Laparoscopy Pelvic Pain Pelvic Pain Postoperative Complications Prospective Studies

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