General Obstetrics and Gynecology: GynecologyFeasibility and clinical outcome of laparoscopic colorectal resection for endometriosis
Section snippets
Patients
Between March 2001 and March 2003, 46 women with colorectal endometriosis were referred to the gynecology department of Tenon Hôspital, Paris, France. Before surgery, all women underwent both MRI and RES. To avoid a possible bias linked to the type of surgery, only women with a muscularis involvement detected by MRI and RES underwent a segmental colorectal resection and were included in this study; those with no muscularis involvement underwent superficial rectal resection (6 women) and were
Preoperative MRI and RES findings
MRI showed colorectal endometriosis in all 40 women (Figure 1, A and B). The median lesion size was 2.5 cm (range: 1-5.5 cm). Colorectal endometriosis was associated with endometriomas in 17 women (42.5%) (bilateral in 6 cases, left-sided in 7 cases, and right-sided in 4 cases), and with uterosacral ligament involvement in 33 women (82.5%). Rectovaginal septum involvement was found in 7 women (17.5%), and uterine adenomyosis in 7 women (17.5%). One woman had cervical involvement.
RES showed
Comment
This study demonstrates that laparoscopic segmental colorectal resection for endometriosis is feasible and significantly improves both gynecologic and digestive symptoms. Rectovaginal fistula was a significant complication, especially when partial vaginal resection was required.
The feasibility and safety of laparoscopic surgical techniques can be estimated on the basis of the laparoconversion rate and perioperative complications. In contrast to previous studies,16, 17, 18, 19 we only enrolled
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