Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital

Introduction: Deep infiltrating endometriosis is a particular form of endometriosis that penetrates the peritoneal surface or it reaches the subserosal neurovascular plexus. Aim: The aim of the authors was to analyze the results of segmental colorectal resections performed for deep infiltrating endometriosis. Method: Between 2009 and 2012, 50 patients underwent segmental rectum or/and sigmoid resection for endometriosis. Results: 21 patients had ultralow rectal resection and 29 patients had low colorectal anastomosis or anterior resection. Concomitant intervention in other organs was required in all cases, including gynecologic procedures (n = 50), additional gynecologic (n = 47), vesical (n = 9) and ureteral (n = 18) resections. The mean number of endometriosis lesions was 2.4±1.8 per patient. In all patients fertility was preserved. Severe surgical complications (Clavien–Dindo stage III or more severe) occurred in 3 patients (6%). Conclusions: The results confirm that segmental bowel resection is an efficient and safe method for the treatment of deep infiltrating colorectal endometriosis. Orv. Hetil., 2014, 155(5), 182–186.

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Robotic Natural Orifice Specimen Extraction with Totally Intracorporeal Anastomosis Associated with Firefly Fluorescence: Bowel Resection for Deep Infiltrating Endometriosis

Journal of Gynecologic Surgery ◽

10.1089/gyn.2019.0139 ◽

2020 ◽

Vol 36 (3) ◽

pp. 128-135

Author(s):

Andre Luiz Gioia Morrell ◽

Gladis Maria P. Anchieta Rodrigues Ribeiro ◽

Thiago Pareja dos Santos ◽

Alexander Charles Morrell ◽

Luciana Pardini Chamie ◽

...

Keyword(s):

Bowel Resection ◽

Intracorporeal Anastomosis ◽

Deep Infiltrating Endometriosis ◽

Natural Orifice ◽

Specimen Extraction ◽

Natural Orifice Specimen Extraction ◽

Infiltrating Endometriosis

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Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis

Case Reports in Obstetrics and Gynecology ◽

10.1155/2013/837903 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

William Kondo ◽

Reitan Ribeiro ◽

Carlos Henrique Trippia ◽

Monica Tessmann Zomer

Keyword(s):

Rectovaginal Fistula ◽

Bowel Resection ◽

Intestinal Anastomosis ◽

Pelvic Abscess ◽

Deep Infiltrating Endometriosis ◽

Laparoscopic Treatment ◽

Spontaneous Healing ◽

Uterosacral Ligaments ◽

Segmental Bowel Resection ◽

Infiltrating Endometriosis

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment.

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Hysteroscopic vaginoscopy. An additional diagnostic tool for recto-vaginal deep infiltrating endometriosis

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.1177/2284026520967865 ◽

2020 ◽

pp. 228402652096786

Author(s):

Brunella Zizolfi ◽

Virginia Foreste ◽

Attilio Di Spiezio Sardo ◽

Pierluigi Giampaolino ◽

Annarita Gencarelli ◽

...

Keyword(s):

Bowel Resection ◽

Uterine Cavity ◽

Accurate Diagnosis ◽

Endometrial Tissue ◽

Deep Infiltrating Endometriosis ◽

Resonance Imaging ◽

Total Hysterectomy ◽

Segmental Bowel Resection ◽

History Of ◽

Infiltrating Endometriosis

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Rectovaginal infiltration is present in 5% to 25% of the patients diagnosed with endometriosis. Accurate diagnosis is imperative for adequate counseling. Hysteroscopic vaginoscopy allows the inspection of the posterior vaginal fornix, not only providing better visualization of the area due to image magnification, but also allowing to obtain biopsy providing pathologic confirmation. We report the case of a 49-year-old nulliparous patient with long history of severe dysmenorrhea, deep dyspareunia and debilitating chronic pelvic pain not responding to medical treatment. On physical exam, recto-vaginal tender nodularity was palpated. Vaginal ultrasound and magnetic resonance imaging confirmed the presence of the nodular formation extending up to the rectum. In-office vaginoscopy revealed a perforated bulge on the uterine cervix, mimicking a double cervix. A biopsy of the nodule confirmed the presence of endometrial tissue, confirming the diagnosis of endometriosis. Patient underwent total hysterectomy with excision of deep infiltrating endometriosis which required segmental bowel resection with diverting loop colostomy. The final pathology confirmed the diagnosis of deep infiltrating endometriosis.

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Segmental bowel resection for deep infiltrating endometriosis

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.14030 ◽

2016 ◽

Vol 123 (8) ◽

pp. 1368-1368 ◽

Cited By ~ 8

Author(s):

AS Kupelian ◽

A Cutner

Keyword(s):

Bowel Resection ◽

Deep Infiltrating Endometriosis ◽

Segmental Bowel Resection ◽

Infiltrating Endometriosis

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Deep infiltrating endometriosis with bowel involvement. Literature review

Siberian medical review ◽

10.20333/25000136-2021-2-5-11 ◽

2021 ◽

pp. 5-11

Author(s):

V.B. Tskhay ◽

◽

A Khudyakov ◽

A Terjung ◽

A.M. Polstianoy ◽

...

Keyword(s):

Operative Treatment ◽

Bowel Resection ◽

Complete Removal ◽

Occurrence Rate ◽

Deep Infiltrating Endometriosis ◽

Childbearing Age ◽

Prevalent Disease ◽

Bowel And Bladder Dysfunction ◽

Bowel Involvement ◽

Infiltrating Endometriosis

Endometriosis is a prevalent disease in females of the childbearing age. It may be accompanied by bowel involvement. In such cases, the most frequently observed lesion locations are the rectum and the rectosigmoid with the occurrence rate of 3-37 %. Treatment of severe forms of deep infiltrating endometriosis with bowel wall involvement is one of the most challenging problems of modern gynaecology. Apart from general intra- and postoperative risks (haemorrhage, infection, direct damage to the organs) or bowel and bladder dysfunction, one of the most severe complications is the development of anastomotic leaks. This article presents a review of literatures dated 2010-2020 searched for in PubMed and Google Scholar databases and devoted to operative treatment of patients with deep infi ltrating endometriosis. We made an emphasis on the effi cacy of the multidisciplinary approach to operative treatment of patients with deep infiltrating endometriosis and bowel involvement. Multidisciplinary laparoscopic treatment has become a standard of medical aid in deep infiltrating endometriosis. Depending on the size of endometrial lesion and the location of bowel involvement, complete removal of the infiltrate or bowel resection is performed in cooperation with an experienced colorectal surgeon. The operative tactics in laparoscopic endometriosis resection, including bowel resection, may provide advantages for both the patients and the healthcare system. The optimal model is to be chosen drawing on the basis of the maximum benefit for the patient.

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