Prä-operative Abschätzung einer tief infiltrierenden Darmendometriose mittels Untersuchungsbefund in der ENZIAN-Klassifikation und der Symptomatik sowie Vergleich mit dem intra-operativen ENZIAN-Befund

Introduction and Hypothesis: There is still no classification for deeply infiltrating endometriosis that is world-wide accepted and combines all features of deep infiltration. We examine if it is possible to classify deeply infiltrating endometriosis using the ENZIAN-classification in the pre-operative stage, if the results are confirmed during surgery using the intra-operative ENZIAN and if there is a statistical association between ENZIAN-features and symptoms. Methods: retrospective analysis of 156 consecutive cases with deeply infiltrating endometriosis of the rectum treated surgically in a level one endometriosis centre. Results: The pre-operative ENZIAN-classification is reliably confirmed by intra-operative findings. 7 out of 10 pre-operative ENZIAN-features were significantly associated with intra-operative features. A statistical association between certain ENZIAN-features and symptoms could not be found. Discussion: The clear association between pre- and intra-operative findings expressed by the ENZIAN-classification shows that we have a useful and reliable tool to document pre-operative findings. This makes it possible to achieve accurate documentation for surgical and non-surgical procedures and follow-up, to have comparable clinical findings that can be used in multi-centre studies or during patient follow up by different examiners over the years. Therapy planning and communication becomes easier for the clinician-patient interaction as well as between clinicians of different specializations (gynecologist, surgeon, urologist) planning a surgical intervention.