Rectal shaving for deep endometriosis infiltrating the rectum: a 5-year continuous retrospective series

Horace Roman, Salwa Moatassim-Drissa, Moatassim-Drissa S, Marty N, Noemie Marty, N Marty, Milles M, Mathilde Milles, Vallée A, Aurélie Vallée, Eulalie Desnyder, Desnyder E, Emanuela Stochino Loi, Stochino Loi E, Carole Abo, Abo C
Fertility and sterility · 2016 · vol. 106(6) , pp. 1438–1445.e2 · doi:10.1016/j.fertnstert.2016.07.1097 · PMID:27565263 · W2509663866
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This retrospective series examined 5-year outcomes of rectal shaving as a surgical technique for deep endometriosis infiltrating the rectum.

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Abstract

OBJECTIVE: To report postoperative outcomes after rectal shaving for deep endometriosis infiltrating the rectum. DESIGN: Retrospective study using data prospectively recorded in the CIRENDO database. SETTING: University tertiary referral center. PATIENT(S): One hundred and twenty-two consecutive patients whose follow-up observation ranged from 1 to 6 years. INTERVENTION(S): Rectal shaving performed using ultrasound scalpel or scissors and plasma energy in 68 and 54 women, respectively. MAIN OUTCOME MEASURE(S): Postoperative digestive function assessed using standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index (GIQLI) and the Knowles-Eccersley-Scott-Symptom Questionnaire (KESS). RESULT(S): Nodules were between 1 and 3 cm, 3 cm in diameter, in 73.7%, 11.5%, and 14.8% of cases, respectively. They were located on the middle (49.2%) and upper rectum (50.8%). Clavien-Dindo 3a, 3b, 4a, and 4b complications occurred in 0.8%, 5.7%, 1.6%, and 0.8% of cases, respectively. Excepting two rectal fistulas (1.6%), the majority of complications were not related to rectal shaving itself. Gastrointestinal scores revealed statistically significant improvement in digestive function and pelvic pain at 1 and 3 years after rectal shaving, but not constipation. Rectal recurrences occurred in 4% of patients, 2.4% of whom had segmental resection, 0.8% shaving, and 0.8% disc excision. Three years postoperatively, the pregnancy rate was 65.4% among patients with pregnancy intention, 59% of whom conceived spontaneously. CONCLUSION(S): Our data suggest that rectal shaving is a valuable treatment for deep endometriosis infiltrating the rectum, providing a low rate of postoperative complications, good improvement in digestive function, and satisfactory fertility outcomes.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Rectal Diseases Ultrasonic Surgical Procedures Ultrasonic Surgical Procedures Ultrasonic Surgical Procedures Ultrasonic Surgical Procedures Adult Adult Colonography, Computed Tomographic Colonography, Computed Tomographic Constipation Constipation Constipation Databases, Factual Databases, Factual Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (39)

Cited by (50)

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