Résection rectale segmentaire et shaving rectal laparoscopiques pour endométriose : morbidité péri-opératoire

Canon, Belle; Collinet, Pierre; Piessen, Guillaume; Rubod, C.

doi:10.1016/j.gyobfe.2013.02.005

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…Study 4 was carried out in a single centre, increasing consistency across surgical approaches. 26 However, different surgeons approach the same procedure differently. Because this study has a flawed measurement between exposure and outcome it suffers from inconsistency of effect.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…In the shaving group, recurrence was 22% (95% CI 2.5–42), while for discoid excision and segmental resection it was 5% (95% CI 0.0–10.9) and 2% (95% CI 0.0–4.6), respectively. Study 4 was carried out in a single centre, increasing consistency across surgical approaches 26 . However, different surgeons approach the same procedure differently.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 12 included studies ten were retrospective cohort studies, 11,[24][25][26][27][28][29][30][31][32] one prospective case-control study, 33 and one RCT. 12 The 11 studies (not including the RCT) included a total of 601 patients in the resection group and 1047 patients in the shaving and discoid resection group.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Heinz-Partington

Costa²,

Martins³

et al. 2021

Aust NZ J Obst Gynaeco

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Background Endometriosis of the bowel can be associated with significant morbidity. Surgery to remove it carries risks. Options include conservative shaving or discoid resection and more radical segmental bowel resection. Aims To determine if more conservative shaving or discoid bowel resection is associated with fewer risks than more radical segmental resection. Material and Methods This study is a systematic review. We considered eligible any cohort, observational or randomised controlled trial (RCT) study of at least ten women per arm comparing conservative vs radical bowel surgery for endometriosis. We divided complications into two groups, major and minor. One additional article was added due to its significance in answering our study question as well as the high quality of the study design as an RCT. Results There were 3041 studies screened. Eleven studies were included (n = 1648). For major complications, the risk ratio for shaving and disc excision vs segmental resection is 0.31 (95% CI 0.21–0.46), while the risk difference is −0.25 (95% CI −0.41 to 0.10). For minor complications, the risk ratio is 0.63 (95% CI 0.36–1.09), while the risk difference is −0.03 (95% CI −0.12 to 0.05). Conclusions Conservative shaving or discoid excision surgery is associated with reduced complications. Previous studies demonstrated a trend toward this finding, but suffered from relatively low participant numbers, increasing the risk of type one statistical error. Our results allow surgeons to make informed choices about potential complications when deciding how to approach bowel endometriosis. The results also allow patients to have more information about the risks. However, outcomes in the studies analysed are heterogenous and are from low‐quality evidence.

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Section: Results Of Individual Studiesmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Heinz-Partington

Costa²,

Martins³

et al. 2021

Aust NZ J Obst Gynaeco

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“…Two surgical approaches are available for rectosigmoid endometriosis: intramuscular layer dissection (shaving) or rectosigmoid bowel resection (segmental or patch). Shaving is a conservative technique with some advantages: shorter operative time, shorter hospitalization time, and fewer peroperative complications[5]. Moreover, resection techniques may lead to more postoperative digestive disabilities compared with shaving, such as unsuccessful evacuatory attempts, feeling of incomplete evacuation, abdominal pain and painful evacuation effort[6].…”

Section: Introductionmentioning

confidence: 99%

Preoperative rectosigmoid endoscopic ultrasonography predicts the need for bowel resection in endometriosis

Desplats

Vitte

Cheyron

et al. 2019

WJG

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BACKGROUNDRectosigmoid endometriosis is an underdiagnosed disease responsible for abdominal pain, transit disorders and rectal bleeding. Two surgical approaches, rectosigmoid bowel resection (segmental or patch) or intramuscular layer dissection (shaving), are available.AIMTo assess whether the lesion features observed via preoperative rectosigmoid endoscopic ultrasonography (RS-EUS) might predict the need for bowel resection.METHODSThis multicentric retrospective study was conducted on patients with rectosigmoid endometriosis who underwent a curative surgical procedure, evaluated by RS-EUS performed by two trained operators, between January 2012 and March 2018. A univariate statistical analysis was performed on nodules’ RS-EUS features (thickness, width, infiltration of the submucosae, presence of a bump into the digestive lumen and presence of multiple rectosigmoid localizations). A multivariate logistic regression was then performed on the significant results.RESULTSOf the 367 patients, 73 patients with rectosigmoid endometriosis were evaluated by RS-EUS and underwent rectosigmoid surgery. After the univariate analysis was completed, thickness, width and infiltration of the submucosae were identified as potential predictive factors for bowel resection. In a multivariate logistic regression model, only thickness appeared to be a significant [odds ratio (OR) = 1.49, 95% confidence interval (CI): 1.04-2.12, P = 0.028] predictive factor for bowel resection. Receiver operating characteristic analysis performed showed that a thickness over 5.20 mm might be used as cut-off with a sensitivity of 76%, a specificity of 81%, and an area under carve = 0.82. The cut-off values for 100% sensitivity and 100% specificity were 0.90 mm and 10.00 mm, respectively. A trend concerning width to predict the need for resection was also observed (OR 1.12, 95%CI: 1.00-1.26, P = 0.054)CONCLUSIONThe presence of a rectosigmoid nodule of endometriosis greater than 5.20 mm thick on RS-EUS might predict the need for bowel resection.

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Use of indocyanine green in endometriosis surgery

Bar-Shavit¹,

Jaillet

Chauvet

et al. 2018

Fertility and Sterility

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Résection rectale segmentaire et shaving rectal laparoscopiques pour endométriose : morbidité péri-opératoire

Cited by 9 publications

References 25 publications

Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Preoperative rectosigmoid endoscopic ultrasonography predicts the need for bowel resection in endometriosis

Use of indocyanine green in endometriosis surgery

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