TY - JOUR
T1 - Laparoscopic rectal resection for severe endometriosis of the mid and low rectum
T2 - Technique and operative results
AU - Ruffo, Giacomo
AU - Sartori, Alberto
AU - Crippa, Stefano
AU - Partelli, Stefano
AU - Barugola, Giuliano
AU - Manzoni, Alberto
AU - Steinasserer, Martin
AU - Minelli, Luca
AU - Falconi, Massimo
PY - 2012/4
Y1 - 2012/4
N2 - Background Although several studies have shown that laparoscopic resection is safe and feasible in bowel endometriosis, limited data are available on the specific treatment for endometriosis of the rectum. The aim of this study is to describe operative and postoperative outcomes after laparoscopic resection of the mid/low rectum for endometriosis. Methods Between 2002 and 2010, 750 patients (median age 33 years) underwent laparoscopic resection of the mid/ low rectum for deep infiltrating endometriosis at a single institution. All operations were performed with a standardized technique by a single surgeon. Results Median operative time was 255 min, and median blood loss 150 ml. Of patients, 7% required blood transfusions. Laparotomic conversion rate was 1.6%. Mechanical low and very low colorectal anastomoses were carried out in 92.5 and 7.5% of patients, respectively. Temporary ileostomy rate was 14.5%. Median length of stay was 8 days. Overall surgical morbidity was 9% with no mortality. Rates of anastomotic leak, rectovaginal fistula, and intraabdominal bleeding were 3, 2, and 1.2%. Forty patients (5.5%) required reoperation. Conclusions Laparoscopic resection of the mid/low rectum for endometriosis can be performed safely with acceptable rates of morbidity/reoperation and with low rates of specific complications, including anastomotic leak and rectovaginal fistula. The very high surgical volume of the operating surgeon is probably one of the most important factors in order to maximize postoperative outcomes.
AB - Background Although several studies have shown that laparoscopic resection is safe and feasible in bowel endometriosis, limited data are available on the specific treatment for endometriosis of the rectum. The aim of this study is to describe operative and postoperative outcomes after laparoscopic resection of the mid/low rectum for endometriosis. Methods Between 2002 and 2010, 750 patients (median age 33 years) underwent laparoscopic resection of the mid/ low rectum for deep infiltrating endometriosis at a single institution. All operations were performed with a standardized technique by a single surgeon. Results Median operative time was 255 min, and median blood loss 150 ml. Of patients, 7% required blood transfusions. Laparotomic conversion rate was 1.6%. Mechanical low and very low colorectal anastomoses were carried out in 92.5 and 7.5% of patients, respectively. Temporary ileostomy rate was 14.5%. Median length of stay was 8 days. Overall surgical morbidity was 9% with no mortality. Rates of anastomotic leak, rectovaginal fistula, and intraabdominal bleeding were 3, 2, and 1.2%. Forty patients (5.5%) required reoperation. Conclusions Laparoscopic resection of the mid/low rectum for endometriosis can be performed safely with acceptable rates of morbidity/reoperation and with low rates of specific complications, including anastomotic leak and rectovaginal fistula. The very high surgical volume of the operating surgeon is probably one of the most important factors in order to maximize postoperative outcomes.
KW - Anastomotic leak
KW - Complications
KW - Endometriosis
KW - Laparoscopy
KW - Rectum
KW - Resection
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U2 - 10.1007/s00464-011-1991-8
DO - 10.1007/s00464-011-1991-8
M3 - Article
C2 - 22038165
AN - SCOPUS:84863207057
VL - 26
SP - 1035
EP - 1040
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 4
ER -