Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case-control study.

Abstract:

OBJECTIVE:To evaluate the efficacy of discoid resection for the treatment of deep infiltrating endometriosis and whether it could be considered to be a valid alternative to the rectosigmoid segmental resection. DESIGN:Case-control study. SETTING:Departments of Obstetrics and Gynecology, Ospedale Sacro Cuore of Negrar, Verona, and Catholic University of the Sacred Heart, Rome, Italy. PATIENT(S):Women with deep infiltrating and intestinal endometriosis divided into study group (48 patients) and control group (88 patients). INTERVENTION(S):All patients underwent laparoscopic endometriosis excision plus discoid rectosigmoid resection (study group) or segmental resection (control group). MAIN OUTCOME MEASURE(S):Short- and long-term outcomes. RESULT(S):In the study group, median operating time was 200 minutes, with a median estimated blood loss of 203 mL. Median ileus was 3 days with a median postoperative hospitalization of 7 days. Early complications were observed in six patients (12.5%), and in two of them (4.16%) a surgical management was necessary. Median follow-up period was 33 months, and five recurrences (10.4%) were registered. In the control group, no significant differences were noticed except for longer operative time, more temporary ileostomy, postoperative fever, and long-term bladder dysfunctions. CONCLUSION(S):Laparoscopic mechanical discoid resection is feasible, markedly improved endometriosis related symptoms, and could be considered as a worthy alternative to classic segmental resection in selected patients.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Fanfani F,Fagotti A,Gagliardi ML,Ruffo G,Ceccaroni M,Scambia G,Minelli L

doi

10.1016/j.fertnstert.2009.03.066

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

444-9

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(09)00636-0

journal_volume

94

pub_type

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