Aggressive surgical management for advanced colorectal endometriosis.
OBJECTIVE
The aim of this study was to evaluate the results of aggressive surgical management in patients with advanced colorectal endometriosis.


METHODS
The medical records of 130 women who had undergone aggressive surgical management of advanced colorectal endometriosis were reviewed. They were then interviewed a mean of 60 months following surgery and asked to rank relief of their symptoms.


RESULTS
The most common symptoms before surgery were pelvic pain, dyspareunia, rectal pain, change in bowel habit, and cyclic rectal bleeding. Colorectal operations included low anterior resection, sigmoid resection, disc excision of the rectal wall, right colectomy, appendectomy, and small bowel resection. At follow-up symptom relief was high, ranging from 100 percent in cyclic bleeding to 91 percent for rectal pain. Mortality and clinical leakage rates were 0 percent, small bowel obstruction 3 percent, and abscess 1 percent. The crude pregnancy rate following surgery was 49 percent.


CONCLUSIONS
These findings strongly support the use of aggressive surgical extirpation of all visible colorectal endometriosis for patients with advanced disease.
Bailey
H R
HR
Department of Surgery, University of Texas Health Science Center at Houston.
Ott
M T
MT
Hartendorp
P
P
D000328:Adult; D003108:Colonic Diseases / Q000453:epidemiology / Q000601:surgery*; D004715:Endometriosis / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D017060:Patient Satisfaction; D012002:Rectal Diseases / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors