title: Surgical treatment of symptomatic colorectal endometriosis.
abstract: The approach to the treatment of bowel endometriosis has varied greatly. In this paper we present 77 consecutive patients with deep colorectal endometriosis treated with a full-thickness resection. Gynecologic procedures included conservative laparotomies for preserving fertility (39 patients); hysterectomy with bilateral salpingo-oophorectomy (29 patients); bilateral salpingo-oophorectomy (2 patients); left salpingo-oophorectomy (1 patient) and resection of pelvic endometriosis in patients with previous ablative surgery (6 patients). A low anterior bowel resection was performed in 68 patients (88.3%); a disc excision of the anterior rectal wall in 5 (6.5%); sigmoid resection in 3 (3.9%), and partial cecal resection in 1 (1.3%). The postoperative febrile morbidity was 10.4%, with no apparent anastomotic leaks. Of 33 patients who attempted to conceive postoperatively, 13 achieved a term pregnancy (39.4%). Complete relief of pelvic symptoms was obtained in 38 patients (49.4%); improvement in 30 (39%); no improvement in 8 (10.4%); and worsening of symptoms in 1 (1.2%). There has been no recurrence of symptomatic bowel endometriosis during 1 to 9 years of follow-up. Full-thickness resection of the colon for the treatment of deep bowel endometriosis is a safe procedure with low morbidity, good postoperative relief of symptoms, and favorable pregnancy rates.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: C
authors.initials: C
authors.lastname: Coronado
authors.forename: R R
authors.initials: RR
authors.lastname: Franklin
authors.forename: E C
authors.initials: EC
authors.lastname: Lotze
authors.forename: H R
authors.initials: HR
authors.lastname: Bailey
authors.forename: C T
authors.initials: CT
authors.lastname: Valdés
mesh_terms: D000328:Adult; D003106:Colon / Q000473:pathology / Q000601:surgery; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D004715:Endometriosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D012007:Rectum / Q000473:pathology / Q000601:surgery