Mapping of bowel occult microscopic endometriosis implants surrounding deep endometriosis nodules infiltrating the bowel

Alexandra Badescu, Badescu A, Horace Roman, Moutaz Aziz, Aziz M, Puscasiu L, Lucian Pușcașiu, Lucian Puscasiu, Claudiu Varlam Molnar, Claudiu Molnar, Molnar C, Huet E, Emmanuel Huet, Jean-Christophe Sabourin, Jean‐Christophe Sabourin, Sabourin JC, Simona Stolnicu
Fertility and sterility · 2015 · vol. 105(2) , pp. 430–434.e26 · doi:10.1016/j.fertnstert.2015.11.006 · PMID:26613653 · W2175166988
article OA: bronze CC0 ⤵ 33 in-corpus citations
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This study mapped occult microscopic endometriosis implants adjacent to deep endometriosis nodules that infiltrated the bowel wall.

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Abstract

ObjectiveTo provide a mapping of bowel occult microscopic endometriosis implants from colorectal specimens removed from patients who had undergone colorectal resection for deep endometriosis infiltrating the rectum.DesignA series of consecutive patients with deep endometriosis infiltrating the rectum or/and sigmoid colon, between January 2013 and December 2013.SettingUniversity tertiary referral center.Patient(s)Twenty-six patients with deep endometriosis infiltrating the rectum or/and sigmoid colon.Intervention(s)Surgical management by colorectal resection.Main outcome measure(s)Twenty-six patients with prospective recording of data (age, clinical history, symptoms, preoperative assessment, and intraoperative findings) underwent colorectal resection for bowel endometriosis. Mapping of occult microscopic endometriosis implants from specimens was established by histologic examination of 1,051 microsection slides taken from transversal macrosections of 3-mm thickness (40 microsections per patient on average).Result(s)The mean (SD) length of colorectal specimens was 110 (42) mm. Microimplants were found at varying distances up to 54 mm from macronodule limits. Multiple macroscopic nodules were identified in five patients (19.2%). In 18 specimens (69%) diffusion of endometriosis microimplants was longitudinal, whereas in 8 specimens (31%) diffusion was concentrated around the macroscopic nodule. Respectively, 31%, 19%, 8%, and 4% of patients presented with endometriosis microimplants at 2, 3, 4, and 5 cm from macroscopic nodules.Conclusion(s)The present data suggest that in patients presenting with deep colorectal endometriosis, microscopically complete excision of rectal endometriosis may be unachievable because of bowel occult microscopic endometriosis implants located far from macroscopic nodules.

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Condition tags

endometriosis

MeSH descriptors

Colon, Sigmoid Endometriosis Rectal Diseases Rectum Sigmoid Diseases Adult Colectomy Colon, Sigmoid Colon, Sigmoid Databases, Factual Endometriosis Endometriosis Female France Hospitals, University Humans Rectal Diseases Rectal Diseases Rectum Rectum

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