Combined transanal and laparoscopic approach for the treatment of deep endometriosis infiltrating the rectum

Valérie Bridoux, Bridoux V, Horace Roman, Roman H, Babak Kianifard, B. Kianifard, Kianifard B, Vassilieff M, Maud Vassilieff, M. Vassilieff, Loïc Marpeau, Marpeau L, L. Marpeau, Michot F, F Michot, Francis Michot, Jean-Jacques Tuech, Tuech JJ, J.-J. Tuech
Human Reproduction · 2011 · vol. 27(2) , pp. 418–426 · doi:10.1093/humrep/der422 · PMID:22158086 · W2079445710
Case report OA: bronze CC0 ⤵ 36 in-corpus citations
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This study describes a transanal rectal disc excision technique using a contour stapler to treat deep infiltrating endometriosis of the rectum, finding it feasible for nodules up to 10 cm from the anal margin and 5 cm in diameter.

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Abstract

BACKGROUND: Two surgical approaches are employed in the treatment of deep infiltrating endometriosis of the rectum (DIER): colorectal resection and nodule excision. In 2009, we introduced a new technique for transanal full thickness disc excision of endometriotic nodules infiltrating the low and middle rectum, using the Contour® Transtar™ stapler (Ethicon Endo-Surgery inc., Cincinnati, OH, USA). The aim of this retrospective study was to describe the technique and to present data on the feasibility of this technique. METHODS: From April 2009 to October 2010, all patients presenting with DIER and undergoing full thickness excision using the Contour® Transtar™ stapler were enrolled in the study. Pre-, intra- and post-operative data were collected and reported. RESULTS: Six nulliparous women were managed using this technique during the study period. The rectal wall discs removed measured from 40 × 45 to 60 × 50 mm. In two cases, microscopic foci were noted on one of the margins but in four cases the limits were clear. Operating time varied from 180 to 450 min. Four women were completely free of post-operative digestive complaints. CONCLUSIONS: Despite the small numbers in this series, our data suggest that the new technique of transanal rectal disc excision using the contour stapler may be applied in patients with infiltrating endometrial nodules of the rectum up to 10 cm from the anal margin and up to 5 cm in diameter. This new procedure promises to be a useful addition to the surgeon's armamentarium in a multidisciplinary approach to deep pelvic endometriosis.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Laparoscopy Proctoscopy Rectal Diseases Adult Adult Anorectal Malformations Anorectal Malformations Anus, Imperforate Anus, Imperforate Anus, Imperforate Cohort Studies Cohort Studies Endometriosis Endometriosis Endometriosis Feasibility Studies Feasibility Studies Female Female

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (28)

Cited by (36)

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