Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis.
OBJECTIVE
This study was undertaken to evaluate the feasibility and complications of laparoscopic segmental colorectal resection for endometriosis and its efficacy on gynecologic and digestive symptoms.


METHODS
After magnetic resonance imaging and rectal endoscopic sonographic evaluation of symptomatic colorectal endometriosis, 40 consecutive women requiring colorectal resection were included in this study. Symptom questionnaires were completed before and after the procedure. Perioperative complications and linear intensity scores for several gynecologic and digestive symptoms were recorded.


RESULTS
Thirty-six women (90%) underwent laparoscopic segmental colorectal resection and 4 required laparoconversion. Major complications occurred in 4 cases (10%), including 3 rectovaginal fistulae and 1 pelvic abscess. Transient urinary dysfunction occurred in 7 women (17.5%). Median follow-up after colorectal resection was 15 months (3-22 months). Median overall preoperative and postoperative pain scores were 8 +/- 1 (range 4-10) and 2 +/- 2 (0-10), respectively ( P < .0001). Nonmenstrual pelvic pain ( P = .0001), dysmenorrhea ( P < .0001), dyspareunia ( P = .0001), and pain on defecation ( P < .0005) were improved by colorectal resection. Lower back pain and asthenia were not improved.


CONCLUSIONS
Our results suggest that laparoscopic segmental colorectal resection for endometriosis is feasible but carries a risk of major postoperative complications. Colorectal resection improved gynecologic and digestive symptoms, and the overall pain score.
Darai
Emile
E
Service de Gynécologie, Obstétrique et Médecine de la Reproduction,Hôpital Tenon, Université Saint-Antoine Paris VI, Assistance Publique des Hôpitaux de Paris, France. emile.darai@tnn.ap-hop-paris.fr
Thomassin
Isabelle
I
Barranger
Emmanuel
E
Detchev
Romain
R
Cortez
Annie
A
Houry
Sydney
S
Bazot
Marc
M
D000328:Adult; D003106:Colon / Q000601:surgery*; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000601:surgery*