Histopathological extent of rectal invasion by rectovaginal endometriosis

A Kavallaris, Andreas Kavallaris, C Köhler, R Kühne-Heid, A Schneider
Human Reproduction · 2003 · vol. 18(6) , pp. 1323–1327 · doi:10.1093/humrep/deg251 · PMID:12773467 · W2115765653
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This study evaluated the histopathological extent of rectovaginal endometriosis in en-bloc surgical specimens, finding involvement of the serosa and muscularis propria in all patients, submucosa in 34%, and mucosa in 10%.

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Abstract

BACKGROUND: We aimed to evaluate the microscopic extent of endometriosis in surgical en-bloc specimens of vaginal skin, rectovaginal septum, cul-de-sac, and part of the rectosigmoid bowel. METHODS: From December, 1997 to October, 2001, 50 patients with the trias of intestinal pain, palpable disease in the rectovaginal septum, and laparoscopic diagnosis of endometriosis of the cul-de-sac and/or rectosigmoid colon underwent combined laparoscopic-vaginal en-bloc resection of the cul-de-sac with partial resection of the posterior vaginal wall and rectum with reanastomosis by minilaparotomy. All surgical specimens were histopathologically evaluated in a standardized fashion. RESULTS: The mean length of the bowel specimen was 7.48 cm. Endometriosis involved the serosa and muscularis propria in all patients, the submucosa in 17 patients (34%), and the mucosa in five patients (10%). After a mean follow-up of 32 months, 90% of patients reported a considerable improvement or were completely free of symptoms and the rate of recurrence was 4% (two patients). CONCLUSIONS: Partial bowel resection indicates the depth and multifocality of endometriosis affecting the recto-sigmoid colon. Such extensive surgery appears justified by the extent of the lesions and the long-term relief of symptoms achieved.

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Condition tags

mesh:D004715endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Rectum Vaginal Diseases Adult Colon, Sigmoid Colon, Sigmoid Endometriosis Endometriosis Female Humans Laparoscopy Mucous Membrane Mucous Membrane Rectal Diseases Rectal Diseases Rectum Sigmoid Diseases Sigmoid Diseases Sigmoid Diseases

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