Feasibility and safety of transvaginal specimen extraction in deep endometriosis colorectal resectional surgery and analysis of risk factors for postoperative complications

Spagnolo, Emanuela; Marí-Alexandre, Josep; Saverio, Salomone Di; Gilabert‐Estellés, Juan; Agababyan, Cristina; García-Casarrubios, Patricia; López, Ana Cristina; González-Cantó, Eva; Pascual, Isabel; Hernández, Alicia

doi:10.1007/s10151-021-02565-x

Cited by 7 publications

(14 citation statements)

References 27 publications

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“…Our data sets are comparable to the results reported by other authors ranging from 2.4 to 13.2% in terms of rectovaginal fistulas, vesicovaginal fistulas, anastomosis stenosis, ureteral fistulas, and bladder fistulas [ 8 , 33 ]. The low rate of recto-vaginal fistulas and low post-operative complications is also supported by a recent study by Spagnolo et al, with 99 patients who, when comparing transvaginal specimen extraction (n = 23) and the classic technique (n = 76), showed no statistically significant differences in term of post-operative complications and recto-vaginal fistula rates between the groups [ 12 ]. Akladios et al, examining a group of 39 patients undergoing bowel resection for DE, observed a post-operative complication rate of 12.5% in those to whom the classic technique was applied and 20% in those who had the NOSE technique, with no statistically significant differences [ 29 ].…”

Section: Discussionmentioning

confidence: 70%

“…In recent years there has been growing interest in the extraction of specimens via transnatural orifices [ 7 – 12 ], i.e. through a transvaginal or transrectal route, thus avoiding the abdominal incisions described in classic techniques (mini-laparotomy), which, though smaller than a laparotomy, can be associated with complications and suboptimal aesthetic results [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, even though there are no universal guidelines recommending which extraction and anastomosis technique should be preferred as an alternative to the classic one, a natural orifice specimen extraction (NOSE) is the most widely used [ 9 – 12 ]. In 2021, however, totally intracorporeal colorectal anastomosis (TICA) was described for the first time by our group [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Totally intracorporeal colorectal anastomosis (TICA) versus classical mini-laparotomy for specimen extraction, after segmental bowel resection for deep endometriosis: a single-center experience

Ianieri,

De Cicco Nardone,

Greco

et al. 2024

Arch Gynecol Obstet

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Purpose The surgical approach to bowel endometriosis is still unclear. The aim of the study is to compare TICA to conventional specimen extractions and extra-abdominal insertion of the anvil in terms of both complications and functional outcomes. Methods This is a single-center, observational, retrospective study conducted enrolling symptomatic women underwent laparoscopic excision of deep endometriosis with segmental bowel resection between September 2019 and June 2022. Women who underwent TICA were compared to classical technique (CT) in terms of intra- and postoperative complications, moreover, functional outcomes relating to the pelvic organs were assessed using validated questionnaires [Knowles-Eccersley-Scott-Symptom (KESS) questionnaire and Gastro-Intestinal Quality of Life Index (GIQLI)] for bowel function. Pain symptoms were assessed using Visual Analogue Scale (VAS) scores. Results The sample included 64 women. TICA was performed on 31.2% (n = 20) of the women, whereas CT was used on 68.8% (n = 44). None of the patients experienced rectovaginal, vesicovaginal, ureteral or vesical fistula, or ureteral stenosis and uroperitoneum, and in no cases was it necessary to reoperate. Regarding the two surgical approaches, no significant difference was observed in terms of complications. As concerns pain symptoms at 6-month follow-up evaluations on stratified data, except for dysuria, all VAS scales reported showed significant reductions between median values, for both surgery interventions. As well, significant improvements were further observed in KESS scores and overall GIQLI. Only the GIQLI evaluation was significantly smaller in the TICA group compared to CT after the 6-month follow-up. Conclusions We did not find any significant differences in terms of intra- or post-operative complications compared TICA and CT, but only a slight improvement in the Gastro-Intestinal Quality of Life Index in patients who underwent the CT compared to the TICA technique.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Totally intracorporeal colorectal anastomosis (TICA) versus classical mini-laparotomy for specimen extraction, after segmental bowel resection for deep endometriosis: a single-center experience

Ianieri,

De Cicco Nardone,

Greco

et al. 2024

Arch Gynecol Obstet

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“…16 The vaginal route for specimen extraction was utilized in all cases in our study which is feasible and secure, as supported by another study as well. 21 …”

Section: Discussionmentioning

confidence: 99%

Bowel Endometriosis Management by Colorectal Resection: Laparoscopic Surgical Technique & Outcome

Limbachiya¹,

Tiwari²,

Kumari³

et al. 2023

JSLS

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Background and Objectives: Bowel deep infiltrating endometriosis (DIE) management by colorectal resection is a complex procedure. The purpose of the present study is to delineate a meticulous approach to the assessment of the patient, step-wise surgical technique, pre, and postoperative care, and its short-term and long-term outcomes. Methods: This is a single-center retrospective study done on patients of bowel DIE managed by colorectal resection between January 1, 2019 to June 30, 2021. Results: There was a significant improvement in the symptomatology of patients post-surgery. Our surgical technique is feasible with acceptable short-term and long-term outcomes. Conclusion: Bowel DIE management can be proficiently executed with a proper diagnostic approach, appropriate surgical expertise with exhaustive pelvic anatomy knowledge especially concerning autonomic nerve plexus.

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“…Hybrid NOTES (natural orifice surgery accompanied by transabdominal access) 1,2 combines the advantages of transabdominal laparoscopic surgery while limiting surgical trauma to the abdominal wall. Among various routes of intra-abdominal access, the transvaginal method is the most appealing one because of its utility and safety.…”

Section: Teaching Pointsmentioning

confidence: 99%

Laparoscopic Low Anterior Resection for Severe Deep Pelvic Endometriosis (Stage IV) With Hybrid Notes Technique for Specimen Extraction and Anvil Insertion

Saeidi

Meroni

Saverio

2023

Diseases of the Colon &Amp; Rectum

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Feasibility and safety of transvaginal specimen extraction in deep endometriosis colorectal resectional surgery and analysis of risk factors for postoperative complications

Cited by 7 publications

References 27 publications

Totally intracorporeal colorectal anastomosis (TICA) versus classical mini-laparotomy for specimen extraction, after segmental bowel resection for deep endometriosis: a single-center experience

Totally intracorporeal colorectal anastomosis (TICA) versus classical mini-laparotomy for specimen extraction, after segmental bowel resection for deep endometriosis: a single-center experience

Bowel Endometriosis Management by Colorectal Resection: Laparoscopic Surgical Technique & Outcome

Laparoscopic Low Anterior Resection for Severe Deep Pelvic Endometriosis (Stage IV) With Hybrid Notes Technique for Specimen Extraction and Anvil Insertion

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