Surgical treatment of deeply infiltrating endometriosis with colorectal involvement

Meuleman, Christel; Tomassetti, Carla; D’Hoore, André; Cleynenbreugel, Ben Van; Penninckx, Freddy; Vergote, Ignace; D’Hooghe, Thomas

doi:10.1093/humupd/dmq057

Cited by 287 publications

(264 citation statements)

References 88 publications

Supporting

Mentioning

224

Contrasting

Unclassified

Order By: Relevance

“…Surgery is generally indicated for patients who did not benefit from the medical treatment or developed recurrent lesion as well as those who presented with a serious complication. Recurrence rate is low after total excision of the lesion (8). Similarly, no recurrence was observed during the follow-up period of our patients.…”

Section: Discussionsupporting

confidence: 65%

Two Cases of Acute Abdominal Intestinal Endometriosis

Kılıç¹,

Terzioğlu²,

Türkay³

et al. 2017

J Emerg Med Case Rep

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 65%

Two Cases of Acute Abdominal Intestinal Endometriosis

Kılıç¹,

Terzioğlu²,

Türkay³

et al. 2017

J Emerg Med Case Rep

View full text Add to dashboard Cite

“…Some authors define rectovaginal septum (RVS) endometriosis as endometriosis involving visceral fascia located between the vagina and rectum with or without extension to the uterosacral ligaments or to the vagina but without bowel M a n u s c r i p t 7 endometriosis [18], while others include obliteration of the pouch of Douglas with or without colorectal infiltration under the term RVS [23].…”

Section: Issues On Fertility and Colorectal Endometriosismentioning

confidence: 99%

“…Another concern is the absence of consensus about indications for colorectal surgery for infertility as well as the type of surgery (rectal shaving, discoid excision or segmental resection) [18]. Moreover, interpretation of fertility results after colorectal surgery is difficult, as most authors fail to distinguish patients with true infertility from those wishing to conceive without proved infertility (no attempt to being pregnant longer than one year preoperatively) and for whom a first line MAR is rapidly proposed).…”

Section: Introductionmentioning

confidence: 99%

Colorectal endometriosis and fertility

Daraı̈

Cohen

Ballester

2017

European Journal of Obstetrics & Gynecology and Reproductiv

View full text Add to dashboard Cite

Objective: The goal of this review was to assess the impact of colorectal endometriosis on spontaneous fertility and the potential benefit of Medically Assisted Reproduction (MAR) (in vitro fertilization and intrauterine insemination) and surgery on fertility outcomes.Study design: MEDLINE search for articles on fertility in women with DIE published between 1990 and December 2015 using the following terms: "deep endometriosis", "deep infiltrating endometriosis", "bowel endometriosis", "colorectal endometriosis", "fertility", "infertility", "IVF-ICSI", "Assisted Reproductive Techniques (ART)", and "MAR".Results: Spontaneous pregnancy rate (PR) in patients undergoing resection of DIE but leaving in situ colorectal endometriosis was 26.5% (95% CI = 14-39). PR after MAR was 27.4% (95% CI = 19-35) and the overall PR was 37.9% (95% CI = 29-37). After colorectal surgery, among the 855 patients with and without proved infertility, the spontaneous PR was 31.4% (95% CI = 28-34) without difference between the groups. PR after MAR was 19.8% (95% CI = 17-22). PR after MAR in patients with and without proved infertility was 21.4% (95% CI = 18-25) and 15.5% (95% CI = 11-20), respectively. The overall PR after colorectal surgery was 51.1% (95% CI = 48-54). Conclusion:Our review supports a potential benefit of surgery on fertility outcomes for women with colorectal endometriosis. Further studies are required to determine whether surgical management should be first-intention or restricted to failure of MAR.

show abstract

“…3. Műtéti specimenek hisztológiai vizsgálata igazolta, hogy az eltávolított bélszakaszok 95,1%-ában a muscularis mucosa, 37%-ában a submucosa és 6,4%-ában a mucosa is érintett volt [31], az esetek mintegy 50%-ában az elváltozás multilocularisnak bizonyult [32], vagyis az endoszkópos mintavétel pozitivitására minimális esély van. 4.…”

Section: Megbeszélésunclassified

Belet infiltráló endometriosis: a gasztroenterológia és a sebészet új kihívása? Vastagbélileust okozó endometriosis három esete és irodalmi áttekintés

et al. 2016

View full text Add to dashboard Cite

Bevezetés: Az endometriosis miatt kezelt betegek száma az utóbbi évtizedekben nőtt és az esetek is előrehaladottab-bak. A belet infiltráló endometriosis legsúlyosabb szövődménye a vastagbélileus. A betegség ezen szövődményéről napjainkig 16 angol nyelvű, a betegek anamnézisét, kivizsgálását leíró esetismertetés jelent meg. Betegek: 2009 óta az I. Nőgyógyászati Klinikán endometriosissal kezelt 535 beteg közül három esetében korábban vastagbél-elzáródás miatt akut sebészeti beavatkozás történt. Eredmények: A betegek (13/21) 59%-ának anamnézisében endometriosisra utaló tünetek vagy endometriosis miatti korábbi kezelés szerepelt. A képalkotó vizsgálatok (ultrahangvizsgálat, komputertomográfia, mágneses rezonanciás vizsgálat) csak egy esetben vetették fel endometriosis gyanúját. Az esetek 61%-ában (13/21) a primer műtét előtt, 24%-ában (5/21) a műtét után történt kolonoszkópia, de egyetlen esetben sem merült fel endometriosis lehetősége. Bár minden esetben ileus alakult ki, a mucosa csupán 5%-ban (1/19) volt infiltrált. Következtetések: Fiatal nőbeteg ileusa hátterében endometriosis is állhat. A másodlagos kolonoszkópos jelek (falmerevség, megtöretés, benyomat) felismerésével a gasztroenterológus segítheti a preoperatív diagnózist, így megelőzhető a műtét felesleges kiterjesztése. Javasolt nőgyógyász bevonása a műtétbe. Orv. Hetil., 2016Hetil., , 157(49), 1960Hetil., -1966 Kulcsszavak: endometriosis, vastagbélileus, kivizsgálás, kolonoszkópia, műtét Bowel endometriosis: new challenge for gastroenterology and surgery? Three cases of endometriosis caused large bowel ileus and review of the literatureIntroduction: A number of the patients suffer from endometriosis increased in the past decades and the cases have became more serious. The most critical complication of bowel endometriosis is the large bowel obstruction. Up to recently, 16 similar case reports of large bowel endomteriosis causing obstruction, with detailed medical history have been published in the literature in English language. Patients: Since 2007 535 female have been treated in the 1st Gynaecological Department with endometriosis, out of them three patients from emergency surgery in the history because of large bowel obstruction. Results: Symptoms suggesting endometriosis or previous intervention due to endometriosis were detected in 59% (13/21) of the cases. Preoperative ultrasound, computertomography, magnetic resonance imaging did not give correct diagnosis. Colonoscopy was carried out before the primary operation in 61% (13/21) and after the surgery in 24% (5/21) of the cases, but none of them confirmed endometriosis. Although all the patients developed obstruction, only in 5% (1/19) of the patients was the mucosa infiltrated by the endometriosis. Conclusions: In a young female patient, intestinal obstruction can be caused by bowel endometriosis. Identification of colonoscopic signs (rigidity, impression, kinking) of endometriosis may help to avoid unnecessary extension of intestinal resection. Gynaecologists should take part in the operations.

show abstract

Surgical treatment of deeply infiltrating endometriosis with colorectal involvement

Abstract: Prospective studies reporting standardized and well-defined clinical outcome after surgical treatment of DIE with colorectal involvement with long-term follow-up are needed.

Cited by 287 publications

References 88 publications

Two Cases of Acute Abdominal Intestinal Endometriosis

Two Cases of Acute Abdominal Intestinal Endometriosis

Colorectal endometriosis and fertility

Belet infiltráló endometriosis: a gasztroenterológia és a sebészet új kihívása? Vastagbélileust okozó endometriosis három esete és irodalmi áttekintés

Contact Info

Product

Resources

About