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Erschienen in: Surgical Endoscopy 5/2005

01.05.2005 | Original article

Laparoscopic colorectal resection for endometriosis

verfasst von: R. Campagnacci, S. Perretta, M. Guerrieri, A. M. Paganini, A. De Sanctis, A. Ciavattini, E. Lezoche

Erschienen in: Surgical Endoscopy | Ausgabe 5/2005

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Abstract

Background

The rectosigmoid colon is affected by deep pelvic endometriosis in 3–37% of cases. In the past, treatment of the affected gastrointestinal tract generally required conversion to conventional surgery. We describe our experience with complete laparoscopic management of deep pelvic endometriosis with bowel involvement.

Methods

From March 1995 to March 2003, 29 consecutive patients with endometriosis requiring laparoscopic intervention were evaluated. In seven patients (24%) colorectal involvement was identified prior to the operation. A low anterior resection was performed in four patients (57%) and a sigmoid resection in three (43%). In all cases, colonoscopy showed a normal mucosa. In all cases, treatment consisted of resection of the bowel involved together with the excision of all other implants. Data analysis included age, previous abdominal operations, previous history of endometriosis, operative time, conversion rate, complications, length of stay, and pain relief.

Results

There were seven patients with colorectal involvement whose median age was 32.8 years (range, 28–40), with a history of previous abdominal operation in two (28%). Preoperative symptoms were as follow: dysmenorrea in four patients (57%), dyspareunia in four (57%), pelvic pain in seven (100%), rectal bleeding in one (14%), and tenesmus in five (71%). Mean operative time was 190 min (range, 165–230). Length of stay was 8.3 days (range, 7–11). There were no anastomotic leak and no major postoperative complication. One patient had temporary urinary retention. At a median follow-up of 38.7 months (range, 1–84), complete relief of pelvic symptoms was achieved in five patients (71%), and there was improvement in one patient. In one patient complaining of persistent pain, a new colonic implant was diagnosed two years after the surgery requiring reoperation.

Conclusions

The results show that provided that the surgeon is highly skilled in laparoscopy, laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement is feasible and effective in nearly all patients.
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Metadaten
Titel
Laparoscopic colorectal resection for endometriosis
verfasst von
R. Campagnacci
S. Perretta
M. Guerrieri
A. M. Paganini
A. De Sanctis
A. Ciavattini
E. Lezoche
Publikationsdatum
01.05.2005
Erschienen in
Surgical Endoscopy / Ausgabe 5/2005
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-8710-7

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