Computed tomography-based virtual colonoscopy in the assessment of bowel endometriosis: The surgeon's point of view

Horace Roman, H. Roman, J. Carilho, Carilho J, Clive Da Costa, C. da Costa, Da Costa C, De Vecchi C, C. de Vecchi, Suaud O, O. Suaud, Michèle Monroc, M Monroc, Monroc M, P Hochain, Patrick Hochain, Hochain P, Vassilieff M, M. Vassilieff, C. Savoye-Collet, Savoye-Collet C, Céline Savoye‐Collet, Saint-Ghislain M, M. Saint-Ghislain
Gynecologie, obstetrique & fertilite · 2015 · vol. 44(1) , pp. 3–10 · doi:10.1016/j.gyobfe.2015.11.008 · PMID:26725882 · W2216930190
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This study explored the utility of computed tomography-based virtual colonoscopy from the surgeon's perspective in evaluating bowel endometriosis.

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Abstract

OBJECTIVE: To discuss the role of computed tomography-based virtual colonoscopy (CTC) in preoperative assessment of bowel endometriosis. METHODS: Retrospective study using data prospectively recorded, including 127 patients with colorectal endometriosis, having undergone CTC for bowel endometriosis. The study was conducted in a tertiary referral center during 38 consecutive months. Preoperative assessment included CTC, magnetic resonance imaging (MRI), endorectal ultrasound (ERUS) and clinical examination. Information concerning identification of deep infiltrating endometriosis (DIE) of the bowel, the length and height of colorectal involvement, stenosis of digestive lumen and associated digestive localizations were compared with intraoperative findings. RESULTS: Sensitivity and specificity of CTC for DIE of the rectum, the sigmoid colon, associated digestive localizations, and stenosis of the digestive lumen were respectively 97% and 84%, 93% and 88%, 84% and 97%, 96% and 96%. Intraoperative estimation of the length of digestive tract involved by DIE was closer to that provided by CTC than those provided by MRI and ERUS. When CTC revealed stenosis of digestive lumen, higher rates of colorectal resection (63% vs. 9.6%, < 0.001) and disc excision (25.9% vs. 11%, 0.03) were recorded. DISCUSSION: For those surgeons using various procedures for management of bowel endometriosis, accurate information on the length and height of bowel involvement, as well as the existence of bowel stenosis enables informed decision regarding the feasibility of conservative techniques versus bowel resection. Preoperative identification of associated localizations above the sigmoid colon is another major advantage related to CTC. CONCLUSIONS: CTC provides accurate data on the length and height of colorectal involvement by DIE, stenosis of digestive lumen and associated lesions of digestive tract, which impact on the choice of surgical procedure.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Intestinal Diseases Surgeons Surgeons Colonic Diseases Colonic Diseases Colonic Diseases Colonography, Computed Tomographic Colonography, Computed Tomographic Colonography, Computed Tomographic Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Endometriosis Female Female Humans Humans

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 (27)

Cited by (17)

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