Surgical outcome and long‐term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis

Renato Seracchioli, R. Seracchioli, G Poggioli, Poggioli G, Gilberto Poggioli, Filippo Pierangeli, Pierangeli F, F Pierangeli, Manuzzi L, Lisa Manuzzi, L Manuzzi, B Gualerzi, Gualerzi B, L. Savelli, V. Remorgida, Valentino Remorgida, M Mabrouk, Mohamed Mabrouk, Stefano Venturoli, S. Venturoli, Venturoli S
BJOG: An International Journal of Obstetrics & Gynaecology · 2007 · vol. 114(7) , pp. 889–895 · doi:10.1111/j.1471-0528.2007.01363.x · PMID:17501958 · W2028568836
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Laparoscopic rectosigmoid resection effectively reduced painful and dysfunctional symptoms in women with deep infiltrating intestinal endometriosis, with improvements maintained long-term for most symptoms except noncyclic pelvic pain.

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Abstract

The aim of this study was to assess the long-term outcome of treating severely symptomatic women with deep infiltrating intestinal endometriosis by laparoscopic segmental rectosigmoid resection. Detailed intraoperative and postoperative records and questionnaires (preoperatively, 1 month postoperatively and every 6 months for 3 years) were collected from 22 women. The estimated blood loss during surgery was 290 +/- 162 ml (range 180-600), and average hospital stay was 8 days (range 6-19). One woman required blood transfusion after surgery. Two cases were converted to laparotomy. One woman had early dehiscence of the anastomosis. Six months after surgery, there was a significant reduction of symptom scores (greater than 50% for most types of pain) related to intestinal localisation of endometriosis (P < 0.05). Score improvements were maintained during the whole period of follow up. Noncyclic pelvic pain scores showed significant reductions (P < 0.05) after 6 and 12 months, but there was a high recurrence rate later. Dysmenorrhoea and dyspareunia improved in 18/21 and 14/18 women with preoperative symptoms, respectively. Constipation, diarrhoea and rectal bleeding improved in all affected women for the whole period of follow up. Laparoscopic segmental rectosigmoid resection seems safe and effective in women with deep infiltrating colorectal endometriosis resulting in significant reductions in painful and dysfunctional symptoms associated with deep bowel involvement.

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Condition tags

endometriosisdie_deep_infiltratingdysmenorrheadyspareunia

MeSH descriptors

Endometriosis Laparoscopy Rectal Diseases Sigmoid Diseases Adult Anastomosis, Surgical Anastomosis, Surgical Endometriosis Female Follow-Up Studies Humans Laparoscopy Length of Stay Postoperative Complications Postoperative Complications Rectal Diseases Reoperation Sigmoid Diseases Surgical Stapling Treatment Outcome

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