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

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

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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    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