Late Impact of the Laparoscopic Treatment of Deep Infiltrating Endometriosis With Segmental Colorectal Resection

Abstract

Background: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. Aim: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. Methods: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. Results: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. Conclusion: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.

Intestinal endometriosis treated by laparoscopic surgery: case series of 5 patients

“…Rocha et al have evaluated laparoscopic surgery in endometriosis surgery with colectomy and report that it is also effective in alleviating abdominal symptoms and preserving fertility [13]. For patients undergoing sigmoidectomy, the mean operative time was 152 min and mean blood loss was 10 mL.…”

Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

“…Some studies summarized their surgical procedure by indicating that there may be no difference in risk between disc resection and segmental bowel resection. Radical technique usually has a positive impact on clinical improvement of gynaecological and intestinal symptoms in patients with bowel involvement, but it requires high-tech comprehensive skill and surgical skill has a greater impact on risk than the surgical approach does [34][35][36]. The complication rate of segmental bowel resection for bowel endometriosis is estimated to be 10-22% [37,38].…”

Densitometria Óssea: Idade E Sexo Versus Percentual De Pacientes Osteopênicos E Osteoporóticos

“…Dando prosseguimento a essa linha de pensamento, Rocha;Martino (2010) explanam sobre as intercorrências do sono normal, motivadas por estresses ocupacionais, essas alterações abrangem situações como: dificuldade de adormecer, rupturas frequentes da continuidade do sono noturno e enfrentamento de conflitos pela manhã para desadormecer, assim repa-se que o esgotamento físico e emocional é um fator de risco para a insônia e os disturbios do sono.…”

“…Pode causar grave prejuízo na qualidade de vida, além de ser um dos principais culpados da infertilidade (ROCHA et al, 2018). Um estudo relatou a detecção de endometriose em 20 a 50% das mulheres que foram submetidas a investigações por infertilidade (ABREU et al, 2017).…”