Laparoscopic management of bowel endometriosis : a report of 54 cases

Objective To estimate the safety and efficacy of laparoscopic management of bowel endometriosis. Methods 54 consecutive patients underwent laparoscopic surgery during June 2008 and May 2012 First Affiliated Hospital of Sun Yat-Sen University for symptomatic bowel endometriosis. A visual analogue scale (VAS) was used to assess the components of bowel endometriosis-related symptoms. Results 31 patients underwent a laparoscopic colorectal resection,15 patients underwent superficial excision with shaving technique while the remaining 8 patients underwent rectosigmoid discoid resections. A signifi cant improvement (P0.05) was confirmed in all endometriosis-related symptoms in VAS scores. In the 14 infertile patients,7 pregnancies occurred with a total cumulative pregnancy rate of 50.0% (7/14),comprising 6 spontaneous singleton pregnancy (1 vaginal delivery,1 cesarean section,2 ongoing pregnancy and 2 abortion),and one singleton pregnancy obtained by IVF-ET (cesarean section). The total complications rate was 24.1%(13/54),including 2 rectovaginal fistula,10 urinary retention,1 pelvic abscess. Conclusion Laparoscopic treatment of severe bowel endometriosis appears to be effective with markedly relieving endometriosis-related symptoms and high rates of pregnancy. Despite the risk of complications,this surgical approach could be exploited as primary treatment of patients with colorectal endometriosis.