Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible?

Landi, Stefano; Ceccaroni, Marcello; Perutelli, A; Allodi, C.; Barbieri, F; Fiaccavento, A; Ruffo, Giacomo; McVeigh, Enda; Zanolla, Luisa; Minelli, Luca

doi:10.1093/humrep/dei324

Cited by 134 publications

(130 citation statements)

References 26 publications

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“…This probably reflects the fact the number of cases of severe disease that we are being referred is increasing. Marpeau et al 21 15.6 6.3 Darai et al 22 17.5 7.5 Camagna et al 23 6.9 Ford et al 11 1.6 Donnez et al 24 0.9 Fedele et al 10 3.6 Landi et al 25 6.6 Koninckx et al 18 3.1 …”

Section: Discussionmentioning

confidence: 99%

Urological and colorectal complications following surgery for rectovaginal endometriosis

Slack

Child

Lindsey

et al. 2007

BJOG

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Objectives To report the short-and medium-term complications of laparoscopic laser excisional surgery for rectovaginal endometriosis.Design Retrospective cohort study.Setting University teaching hospital, UK. Methods Women were identified from operative database, and a case note review was performed. Data for surgical outcome and surgical complications were collected.Main outcome measures Rates of urinary tract and colorectal complications.Results A total of 128 women underwent surgery. Of these, 32 required intraoperative closure of a rectal wall defect, including 3 segmental rectosigmoid resections. There were three rectovaginal fistulae and one ureterovaginal fistula. Ureteric damage occurred in two women, and five women suffered postoperative urinary retention. The risk of intraoperative bowel intervention was increased in women who complained of cyclical rectal bleeding.Conclusion Laparoscopic laser excision of rectovaginal endometriosis is a safe procedure with similar, if not lower, complication rates to other published surgical series.

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Section: Discussionmentioning

confidence: 99%

Urological and colorectal complications following surgery for rectovaginal endometriosis

Slack

Child

Lindsey

et al. 2007

BJOG

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“…In the Fallopian tubes, endometriosis foci maybe found adjacent to embryonic duct remnants, and the histological evaluation of those lesions suggests the existence of a gradual transformation from embryonic remnants epithelium to endometrial glands [41]. Downway into the pelvis, it is observed that the pelvic sidewalls are frequent sites for endometriotic lesions, both superficial and retroperitoneal [42,43]. The pelvic sidewalls correspond to the posterior leaf of the broad ligaments, and, as previously stated, those are folds of peritoneum brought together by the fusion of the Müllerian ducts.…”

Section: Hoxa10 May Influence the Formation Of Misplaced Endometrial mentioning

confidence: 99%

The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

Zanatta

Rocha

Carvalho³

et al. 2010

J Assist Reprod Genet

168

109

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Purpose Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease.Methods This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility. Result The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/ HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Müllerian tract. Conclusions Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis.

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“…There were also five nonsystematic revisions published [3,28,[32][33][34]. In some of the studies, a radical treatment was assessed [5,13,15,[25][26][27][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56], while others assessed a conservative one [57][58][59][60][61][62][63]. There were six nonrandomized papers in which groups of patients with different therapeutic options were compared [30,[35][36][37][38][39].…”

Section: Resultsmentioning

confidence: 99%

“…Initially, the majority of papers defended a conservative surgical approach directed toward the extirpation or ablation of the endometriosic lesions with minimal excisional surgery of the rectum [6,12,[65][66][67][68]. However, in the last decade, multiple authors have proposed more aggressive techniques including intestinal resection, especially in those cases with an affected muscularis propia of the rectum but also in those having an intact mucosa [5,13,15,[25][26][27][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. The argument used for the practice of this radical surgery is that of achieving the greatest resection possible of the endometriosic lesions, diminishing the postoperative symptomatology and avoiding any early relapse of the disease [41,42].…”

Section: Radical Surgery With Intestinal Resectionmentioning

confidence: 99%

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Surgical treatment of rectovaginal endometriosis with rectal involvement

et al. 2011

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Rectovaginal endometriosis (RVE) is one of the most serious and incapacitating forms of presentation of this disease. Traditionally, medical treatment has not been considered effective for the majority of patients, being surgery the only reasonable and therapeutic choice in these cases. This exposes patients to a potentially serious morbidity, thus a careful evaluation should be done by a surgical board considering the impact of the disease as well as the quality of life of the patients. The main surgical techniques used are the shaving of the rectal wall affected by the endometriosic implants, the discoid excision of the front rectal wall, and the segmental intestinal resection, and there is no consensus concerning which is the most effective and suitable between them. The bibliography published in the last 10 years relating to the surgical treatment of RVE is being reviewed with the intention of updating the knowledge base about the topic and looking for common ground between different studies, allowing us to come closer to reaching a consensus about treatment for this pathology.

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Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible?

Abstract: Laparoscopic nerve-sparing complete excision of endometriosis seems to be feasible and offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique. Larger series with longer follow-up are needed to confirm our results.

Cited by 134 publications

References 26 publications

Urological and colorectal complications following surgery for rectovaginal endometriosis

Urological and colorectal complications following surgery for rectovaginal endometriosis

The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

Surgical treatment of rectovaginal endometriosis with rectal involvement

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