Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case-control study
Received 13 January 2009; received in revised form 11 March 2009; accepted 16 March 2009. published online 27 April 2009.
Objective
To evaluate the efficacy of discoid resection for the treatment of deep infiltrating endometriosis and whether it could be considered to be a valid alternative to the rectosigmoid segmental resection.
Design
Case-control study.
Setting
Departments of Obstetrics and Gynecology, Ospedale Sacro Cuore of Negrar, Verona, and Catholic University of the Sacred Heart, Rome, Italy.
Patient(s)
Women with deep infiltrating and intestinal endometriosis divided into study group (48 patients) and control group (88 patients).
Intervention(s)
All patients underwent laparoscopic endometriosis excision plus discoid rectosigmoid resection (study group) or segmental resection (control group).
Main Outcome Measure(s)
Short- and long-term outcomes.
Result(s)
In the study group, median operating time was 200 minutes, with a median estimated blood loss of 203 mL. Median ileus was 3 days with a median postoperative hospitalization of 7 days. Early complications were observed in six patients (12.5%), and in two of them (4.16%) a surgical management was necessary. Median follow-up period was 33 months, and five recurrences (10.4%) were registered. In the control group, no significant differences were noticed except for longer operative time, more temporary ileostomy, postoperative fever, and long-term bladder dysfunctions.
Conclusion(s)
Laparoscopic mechanical discoid resection is feasible, markedly improved endometriosis related symptoms, and could be considered as a worthy alternative to classic segmental resection in selected patients.
aDivision of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy
bDivision of General Surgery, “Sacro Cuore” Hospital, Negrar, Italy
cDivision of Obstetrics and Gynecology, “Sacro Cuore” Hospital, Negrar, Italy
Reprint requests: Francesco Fanfani, M.D., Division on Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy (FAX: +39-06-35508736).
F.F. has nothing to disclose. A.F. has nothing to disclose. M.L.G. has nothing to disclose. G.R. has nothing to disclose. M.C. has nothing to disclose. G.S. has nothing to disclose. L.M. has nothing to disclose.
ABSTRACT