Outcome after rectum or sigmoid resection: a review for gynecologists.
It remains unclear when to perform a discoid or segmental bowel resection for large endometriotic nodules with intestinal invasion. Moreover, endometriosis series are rather small to fully evaluate functional consequences of bowel resection. We therefore reviewed the incidence of leakage and functional problems after anterior and sigmoid resection as reported in the surgical literature albeit for other indications. Endoscopic resection clearly is feasible but requires an experienced surgeon. The incidence of leakage is not different after hand-sewn or stapled anastomosis, but is higher after a low rectum resection than after a sigmoid resection. Similarly, functional bowel problems are higher after a low rectum resection than after sigmoid resection. Low rectum resection in addition can be associated with functional bladder problems and sexual disturbances as anorgasmia. In conclusion, short- and long-term complications are much higher after a low rectum than after a sigmoid resection. This seems to be important in making the decision to perform a discoid or a segmental bowel resection for severe endometriosis.
Ret Dávalos
María Lorena
ML
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. lorenaret@hotmail.com
De Cicco
Carlo
C
D'Hoore
Andre
A
De Decker
Bert
B
Koninckx
Philippe Robert
PR
D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery*; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D020127:Recovery of Function; D012007:Rectum / Q000473:pathology / Q000601:surgery*