Laparoscopic treatment of deep pelvic endometriosis with rectal involvement

Paola De Nardi, Nadine Osman, Stefano Ferrari, Michele Carlucci, Paola Persico, Carlo Staudacher

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

PURPOSE: Our study aimed to evaluate the feasibility and outcome of laparoscopic excision of deep pelvic endometriosis with extensive rectal involvement causing severe symptoms. METHODS: Ten patients, mean age 32 years (range, 27Y43), with deep pelvic endometriosis and rectal wall involvement, requiring surgical resection, were studied since January 2004. Prior to surgery and 6 months postsurgery, patients completed a 100-point rank questionnaire on intensity of intestinal and extraintestinal symptoms. A laparoscopic approach was performed by a team of a gynecologist and colorectal surgeons. RESULTS: At surgery, complete excision of infiltrating endometriosis was achieved, with 7 low rectal resections, 2 rectosigmoid resections, and 1 proctectomy with coloanal anastomosis. Additional procedures were: ureter resections (n = 2) with one reimplantation in the bladder, left ovariectomies (n = 2), ovarian endometrioma resections (n = 4), and laser ablation of superficial peritoneal lesions (n = 4). In four cases, a laparotomic conversion was needed. Mean follow-up was 27.6 months (range, 18Y37). Neither intraoperative nor postoperative serious complications were observed. All the patients experienced significant improvement of intestinal and extraintestinal symptoms. CONCLUSIONS: Laparoscopic resection of deep pelvic endometriosis with rectal involvement can be successful in improving digestive and gynecologic symptoms; however, this approach is challenging with a high rate of laparotomic conversion.

Original languageEnglish
Pages (from-to)419-424
Number of pages6
JournalDiseases of the Colon and Rectum
Volume52
Issue number3
DOIs
Publication statusPublished - Mar 2009

Fingerprint

Endometriosis
Therapeutics
Replantation
Laser Therapy
Ovariectomy
Ureter
Urinary Bladder

Keywords

  • Deep pelvic endometriosis
  • Laparoscopic rectal resection
  • Laparoscopy
  • Rectal endometriosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

De Nardi, P., Osman, N., Ferrari, S., Carlucci, M., Persico, P., & Staudacher, C. (2009). Laparoscopic treatment of deep pelvic endometriosis with rectal involvement. Diseases of the Colon and Rectum, 52(3), 419-424. https://doi.org/10.1007/DCR.0b013e318197d716

Laparoscopic treatment of deep pelvic endometriosis with rectal involvement. / De Nardi, Paola; Osman, Nadine; Ferrari, Stefano; Carlucci, Michele; Persico, Paola; Staudacher, Carlo.

In: Diseases of the Colon and Rectum, Vol. 52, No. 3, 03.2009, p. 419-424.

Research output: Contribution to journalArticle

De Nardi, P, Osman, N, Ferrari, S, Carlucci, M, Persico, P & Staudacher, C 2009, 'Laparoscopic treatment of deep pelvic endometriosis with rectal involvement', Diseases of the Colon and Rectum, vol. 52, no. 3, pp. 419-424. https://doi.org/10.1007/DCR.0b013e318197d716
De Nardi, Paola ; Osman, Nadine ; Ferrari, Stefano ; Carlucci, Michele ; Persico, Paola ; Staudacher, Carlo. / Laparoscopic treatment of deep pelvic endometriosis with rectal involvement. In: Diseases of the Colon and Rectum. 2009 ; Vol. 52, No. 3. pp. 419-424.
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