Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques

Beraldo, Fernando Bray; Pereira, Ana Maria Gomes; Gazzo, Cláudia; Santos, Marcelo F.; Lopes, Reginaldo Guedes Coelho

doi:10.1055/s-0038-1660827

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…This may be related to the memory of pain not obeying menstrual cyclicity, to dysmenorrhea topping all other pain complaints, or to the amenorrhea promoted by the treatment. Intestinal complaints, in turn, may signal intestinal involvement and require additional evaluation [17].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function

Vieira¹,

Coelho²,

Gomes³

et al. 2021

CMR

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Objectives: Considering the prevalence of endometriosis in reproductive-age women and its negative impact on life quality, the authors of the present research intended to evaluate the impact of clinical treatment on the sexual function of patients with deep infiltrating endometriosis treated at the Endometriosis and Chronic Pelvic Pain Clinic of HSPE-FMO. Methods: A prospective and comparative observational study was conducted between May 2015 and July 2019 in which data from 43 patients with presumed deep endometriosis were analyzed, including age, parity, surgical and obstetric history and Female Sexual Function Index (FSFI questionnaire). Statistical analysis was performed using multiple regression in order to compare the variables. Results: The mean age of the women who were studied was 39.16 years; all patients were symptomatic and most had rectosigmoid endometriosis (65,1%). The median FSFI total score before treatment was 25.06, with 60,5% of the women classified as having a sexual dysfunction. There was a risk for sexual dysfunction to become permanent following clinical treatment when this dysfunction was established previously. The Poisson multiple regression showed that sexual dysfunction before treatment was associated with a lower FSFI total score after treatment and dysfunction before treatment had a direct correlation with final score smaller than 26.55. Considering the FSFI total scores before and after clinical treatment, there was no significant difference in the improvement rate between groups. Conclusions: Most patients did not show improvement in sexual function after clinical treatment.

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Section: Discussionmentioning

confidence: 99%

“…Faced with a clinical condition compatible with endometriosis, treatment with hormonal contraceptives and nonsteroidal anti-inflammatory drugs is considered the firstline treatment [3,16]. Surgery is reserved for cases that do not respond satisfactorily to clinical treatment or present with some degree of organ involvement [3,15,17,18].…”

Section: Introductionmentioning

confidence: 99%

Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function

Vieira¹,

Coelho²,

Gomes³

et al. 2021

CMR

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“…The intersphincteric fistula can safely be treated by lay-open fistulotomy or fistulectomy as recommended in several guidelines [3][4][5]. Nonetheless, variations in clinical practice have been reported depending on the patient's gender, location of the fistula (anterior/posterior), surgeon's choice, and geographic regions [6,7].…”

Section: Marsupialization Of Fistulotomy Wound In An Intersphincteric...mentioning

confidence: 99%

“…The gold standard for bowel endometriosis diagnosis is endovaginal ultrasound and MRI, with the use of colonoscopy being controversial [4,6]. Three surgical techniques have been described for rectal endometriosis: shaving, discoid and segmental resection [7]. When endometriosis presents in other intestinal locations, surgical treatment is individualized, with bowel resection indicated if there are symptoms of obstruction or bleeding or if malignancy cannot be excluded [8].…”

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confidence: 99%

Laparoscopic ileocaecal resection with intracorporeal anastomosis for bowel endometriosis—a video vignette

et al. 2022

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Video S1 describes the technique in a step-by-step approach, using large overlay windows and eye-catching animations for an easier understanding of the surgical procedures (including parietal and pelvic totally laparoscopic peritonectomy). Of interest, there is also an intraoperative diagnosis of rare bilateral inguinal channel dissemination with removal of the affected peritoneum. After radical surgery, hyperthermic chemotherapy perfusion of peritoneum was performed using laparoscopic trocars for HIPEC inflow and outflow catheters.We present this video because it could be of interest to Colorectal Disease readers as this technique is quite new and not widely used.

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“…presentan 48 pacientes con resección discoide, con una tasa de complicaciones severas de 12,5%, entre ellas sangrado masivo que requiere transfusiones, 1 paciente con una fístula rectovaginal y 2 casos de reoperaciones. Bray-Beraldo13 , describe sus resultados en 32 pacientes que se sometieron a resección colorrectal por endometriosis (shaving rectal, resección segmentaria de recto, resección discoide de recto, rectosigmoidectomía, apendicetomía y shaving de ileon). Reporta sólo 2 complicaciones, una fístula anastomótica colorrectal y una fístula recto vaginal que requiere reoperación e ileostomía.…”

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Tratamiento quirúrgico de la endometriosis pélvica profunda con compromiso colorrectal

et al. 2019

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Surgical treatment of deep pelvic endometriosis with colorectal involvement Introduction: In endometriosis, intestinal involvement affects up to 12% of patients, compromising the rectum and the rectosigmoid junction in 90% of cases. Aim: Describe the experience of the Coloproctolgy and Gynecology Team of the Clínica Alemana de Santiago in the surgical treatment of deep pelvic endometriosis with colorectal involvement. Materials and Methods: Retrospective study based on the database of patients with endometriosis treated between January 2015 and April 2018. The inclusion criteria were patients with deep pelvic endometriosis clinic, who had colorectal involvement and who had been treated with rectal shaving, discoid resection or segmental resection. Electronic clinical records, operative protocols and definitive biopsies were reviewed. Results: Twenty-five patients with a median age of 35 years were recruited. The main symptom of consultation was dysmenorrhoea and the most frequent digestive symptom was dyschezia. In 8 patients a rectal shaving was performed, in 7 a sigmoidectomy, in 9 a discoid resection and in 1 patient a tiflectomy. The only reported post-operative complication was low gastrointestinal bleeding in 4 of the 25 patients (Clavien-Dindo I and IIIa). A median follow-up of 13 months was achieved, to date 3 patients have been diagnosed with some type of recurrence. Conclusion: It is important that the surgery to be performed guarantees low morbidity and recurrence. The results in our center are encouraging, which makes us believe that surgical treatment could be a good alternative in deep pelvic endometriosis with colorectal involvement.

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Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques

Abstract: The studied sample consisted of highly symptomatic women. A high prevalence of deep infiltrative endometriosis lesions was found located in the rectum and sigmoid region, and their size correlated directly with the extent of the surgical resection performed.

Cited by 11 publications

References 33 publications

Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function

Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function

Laparoscopic ileocaecal resection with intracorporeal anastomosis for bowel endometriosis—a video vignette

Tratamiento quirúrgico de la endometriosis pélvica profunda con compromiso colorrectal

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