Consensus on Recording Deep Endometriosis Surgery: the CORDES statement

Vanhie, Arne; Meuleman, Christel; Tomassetti, Carla; Timmerman, Dirk; D’Hoore, André; Wolthuis, A.; Cleynenbreugel, Ben Van; Dancet, Eline; Broeck, Uschi Van den; Tsaltas, Jim; Renner, Stefan P.; Ebert, Andreas D.; Carmona, Francisco; Abbott, Jason; Stepniewska, AK; Taylor, H.; Saridogan, E.; Mueller, Michael D.; Keckstein, J.; Pluchino, Nicola; Janik, G.; Zupi, Errico; Minelli, Luca; Cooper, Mark S.; Dunselman, G.A.J.; Koh, C.; Abrão, Maurício Simões; Chapron, Charles; D’Hooghe, Thomas

doi:10.1093/humrep/dew136

Cited by 21 publications

(23 citation statements)

References 10 publications

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“…Endometriosis is being worked on by several initiatives with different scopes, either published as report or study protocol [31,33,34,40] or not published yet but provided to authors of this manuscript [personal communication with Katy Vincent, Email during June 2018]. Considering this work is required, thus, following COMET recommendation of careful consideration of previous work in the field of interest [12], it was therefore necessary to break down this consensus process into two different arms, at least referring to COS domains.…”

Section: Information Sourcesmentioning

confidence: 99%

“…Regarding breast surgery and sternotomy, COS considerations for postoperative pain have not been worked on yet, despite some effort to harmonize outcome assessment in general for reconstructive breast surgery [29,30]. Some initiatives have worked on COS for endometriosis [31][32][33][34], but again, postoperative pain was not addressed. For all surgical procedures, perioperative pain management is characterized by a short duration of intervention (regularly for some days up to 1 or 2 weeks after surgery), and ideally supporting quick recovery and regain of functioning.…”

Section: Introductionmentioning

confidence: 99%

“…For endometriosis, previous results [31][32][33][34]40] of initiatives specifically dedicated to study and improve treatment of endometriosis will be provided to the IMI PROMPT consensus panel after deciding about main aims of perioperative pain management in patients with endometriosis. This will be used in order to subsequently decide whether these recommended domains serve the purpose of capturing effectiveness in perioperative pain management in endometriosis or if modifications are needed.…”

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confidence: 99%

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Developing consensus on core outcome domains and measurement instruments for assessing effectiveness in perioperative pain management after sternotomy, breast cancer surgery, total knee arthroplasty, and surgery related to endometriosis

Kaiser

Liedgens

Meißner

et al. 2020

Trials

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Introduction Evidence synthesis of clinical trials requires consistent outcome assessment. For pain management after surgery, inconsistency of effectiveness assessment is still observed. A subproject of IMI-PainCare (Innovative Medicine Initiatives, www.imi-paincare.eu) aims for identifying core outcome domains and measurement instruments for postoperative pain in four surgical fields (sternotomy, breast cancer surgery, total knee arthroplasty, and surgery related to endometriosis) in order to harmonize outcome assessment for perioperative pain management. Methods A multifaceted process will be performed according to existing guidelines (Core Outcome Measures in Effectiveness Trials (COMET), COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)). In a first step, outcome domains will be identified via systematic literature review and consented on during a 1-day consensus meeting by 10 stakeholder groups, including patient representatives, forming an IMI PROMPT consensus panel. In a second step, outcome measurement instruments regarding the beforehand consented core outcome domains and their psychometric properties will be searched for via systematic literature review and approved by COSMIN checklist for study quality and scale quality separately. In a three-step online survey, the IMI PROMPT consensus panel will vote for most suitable measurement instruments. The process is planned to be conducted between 11/2017 (systematic literature review on common outcome domains) and 3/2022 (final voting on core outcome measurement).

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Section: Information Sourcesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Developing consensus on core outcome domains and measurement instruments for assessing effectiveness in perioperative pain management after sternotomy, breast cancer surgery, total knee arthroplasty, and surgery related to endometriosis

Kaiser

Liedgens

Meißner

et al. 2020

Trials

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“…Deep endometriosis (DE) affecting the rectosigmoid can cause symptoms such as dyschezia, dysmenorrhea, variable digestive complaints and/or infertility 1–3 . In cases in which medical treatment fails, surgical resection either by discoid resection (DR) or segmental resection (SR) is often the treatment of choice.…”

Section: Introductionmentioning

confidence: 99%

Transvaginal sonography accurately measures lesion‐to‐anal‐verge distance in women with deep endometriosis of the rectosigmoid

Aas-Eng

Dauser

Lieng

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives First, to investigate the accuracy of transvaginal sonography (TVS) for presurgical evaluation of the distance between the most caudal part of the endometriotic lesion and the anal verge (lesion‐to‐anal‐verge distance (LAVD)) in women with rectosigmoid deep endometriosis (DE), compared with intraoperative measurement (IOM). Second, to assess the agreement between anastomosis height and LAVD measured using TVS. Methods This was a prospective observational multicenter study of symptomatic women who were scheduled for surgical treatment of rectosigmoid DE, by either discoid or segmental resection, between April 2017 and September 2019. Presurgical TVS was performed to evaluate the LAVD in two ways, depending on the level of the lesion. Method 1: for lesions at the level of the rectovaginal septum (RVS), the caudal part of the lesion was identified on TVS and an index finger was placed on the TVS probe at the level of the anal verge. The probe was withdrawn and the distance from the tip of the TVS probe down to the index finger was measured using a ruler, representing the LAVD. Method 2: for lesions above the RVS, the distance between the caudal part of the lesion and the lower lip of the posterior cervix was measured in a frozen image (LAVD‐1), and the distance between the lower lip of the posterior cervix and the anal verge (LAVD‐2) was measured using Method 1. These two measurements (LAVD‐1 and LAVD‐2) were added together and the result represented the total LAVD. During surgery, a rectal probe was used to perform IOM of LAVD, which was considered as the gold standard test. Agreement between LAVD measured using TVS and the IOM was assessed using Bland–Altman analysis. The intraclass correlation coefficient (ICC) for absolute agreement and Spearman's correlation coefficient were also calculated. Systematic and proportional bias were tested for significance using the paired t‐test. Similar analysis was performed to assess agreement between LAVD measured using TVS and anastomosis height. Results A total of 147 consecutive women were considered eligible for inclusion. Fourteen women were excluded initially. Thirty‐four discoid resections and 102 segmental resections were performed; both procedures were performed in three women. Two more women were excluded from the final analysis because the measurements represented extreme outliers. The mean LAVD measured using TVS was 114.8 ± 36.5 mm and the mean IOM was 116.9 ± 42.3 mm. There was no statistically significant difference between LAVD measured using TVS and IOM (mean difference, –2.12 mm (95% CI, –6.33 to 2.05 mm); P = 0.32). Bland–Altman analysis showed that there was good agreement between the two methods. The ICC was 0.81 (95% CI, 0.74–0.86) and Spearman's correlation coefficient was 0.68 (95% CI, 0.56–0.77). The mean difference between LAVD measured using TVS and anastomosis height was statistically, but not clinically, significant (mean difference, 10.25 mm (95% CI, 5.94–14.32 mm); P = 0.0005), and the ICC was 0.78 (95% CI, 0.66–0.85). Conclus...

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“…Symptomatic deeply infiltrating rectovaginal endometriosis with bowel involvement is a diagnostic and therapeutic challenge [ 1 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

Ebert¹

2018

Case Reports in Obstetrics and Gynecology

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A 27-year-old patient suffering from deeply infiltrating rectovaginal endometriosis was treated with 2 mg/day dienogest vaginally for 3 months. The therapy was tolerated very well. The patient reported less side effects compared to the oral use of dienogest. After 3 months of dienogest treatment, the rectovaginal gynecological examination identified the visible vaginal part of endometriosis in remission. The firm endometriosis node approximately 3 cm in size and approximately 10 cm ab ano was still palpable, but it was much less painful. The laboratory values for luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were unremarkable, with an LH/FSH quotient of 0.7 during dienogest treatment, while 17-β estradiol and progesterone were suppressed. At palpation and vaginal ultrasonography, there was no change in the findings before and after 3 months of dienogest treatment, but the patient was now de facto asymptomatic. To the best of our knowledge, this is the first report of a vaginal dienogest treatment in symptomatic deeply infiltrating rectovaginal endometriosis. Vaginal administration of dienogest should receive further investigation in pharmacokinetic and clinical studies.

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Consensus on Recording Deep Endometriosis Surgery: the CORDES statement

Cited by 21 publications

References 10 publications

Developing consensus on core outcome domains and measurement instruments for assessing effectiveness in perioperative pain management after sternotomy, breast cancer surgery, total knee arthroplasty, and surgery related to endometriosis

Developing consensus on core outcome domains and measurement instruments for assessing effectiveness in perioperative pain management after sternotomy, breast cancer surgery, total knee arthroplasty, and surgery related to endometriosis

Transvaginal sonography accurately measures lesion‐to‐anal‐verge distance in women with deep endometriosis of the rectosigmoid

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

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