EP27.01: Rectal endometriotic nodule volume (RENV) and angle of infiltrating endometriotic rectal nodule (AIERN): ultrasonographic markers of severity for DIE

The lesions of the rectum, with or without involvement of rectovaginal septum, is a major surgical problem whose decision on the type of surgery is, in most cases, intraoperative. Two simple methods of ultrasound measurement for predicting severe DIE: angle of infiltrating endometriotic rectal nodule (AIERN) and Rectal endometriotic nodule volume (RENV) proposed. A review was performed retrospective images between January 2011 and October 2015, obtaining 62 nodular bowel lesions of anterior layer of rectosigmoid. All patients were operated by laparoscopic technique (shaving:48, resection termino-terminal: 12 and discoidal resection: 2) for the same surgical equipment and histology for DIE was confirm. In each one of the nodule image was determinated the angle of infiltrating and rectal lesion volume. AIERN measurement was determinated with 3 points: the proximal it's located at the midpoint of healthy muscle layer of the proximal rectosigmoid (1), the apex is located at the deepest point of the infiltrative lesion (2) and the distal end is at the midpoint of the lowermost healthy muscle layer (3) figure. Later the angule was calculated and determined using ROC curve point with more significant court relating with bowel resection. RENV was calculated with ellipse formula and the best point ROC curve related to bowel resection was determinated. For AIERN was chosen an equal or lower angle of 97.69 ° as increased risk of bowel resection (81.82% sensitivity; 78.43% Specificity; LHR + 3.79;LHR - 0.23;area under the curve 0.831 ; p 0.0006). For RENV was chosen an equal or greater volume of 2.6578 cm3 as increased risk of bowel resection (83.83%sensitivity; specificity 80.36%; LHR + 4,24; LHR - 0.21;under the curve area 0.833; p <0.0001). Sonographic markers RENV and AIERN are useful for predicting rectal lesions with possible rectal stenosis and subsequent bowel resection.