Laparoscopic treatment of deep endometriosis with segmental colorectal resection: short-term morbidity.
OBJECTIVE
Adequate surgical treatment of severe deep endometriosis requires complete excision of all implants, but the modality of bowel resection is still debated. We describe the results of our experience as a tertiary care endometriosis referral center in complete laparoscopic management of deep pelvic endometriosis with bowel involvement.


METHODS
A prospective single-center study (Canadian Task Force classification II-1).


METHODS
In Sacro Cuore General Hospital of Negrar, Italy.


METHODS
One hundred ninety-two women treated with laparoscopic excision of deep endometriosis and segmental colorectal resections were evaluated.


METHODS
From January 2003 through December 2005 we registered all consecutive patients laparoscopically treated for deep endometriosis who also were having segmental bowel resection.


RESULTS
Data analysis included age, weight, body mass index, history of endometriosis, preoperative symptoms, parity, infertility, operative procedures, operating time, conversion, intraoperative and postoperative morbidity, recovery of bladder and bowel function, and discharge from hospital. We report our results in terms of feasibility and short-term morbidity. Radicality was achieved in 91.5% of patients. Laparoconversion occurred in 5 cases (2.6%). Major complications that required repeat operation occurred in 20 cases (10.4%): Nine anastomosis leakages (4.7%), 3 uroperitoneum (1.6%), 4 hemoperitoneum (2.1%), 1 pelvic abscess (0.5%), 1 bowel perforation, 1 intestinal obstruction, and 1 sepsis. Minor complications occurred in 50 patients (26%).


CONCLUSIONS
Laparoscopic segmental colorectal resection for endometriosis is feasible and, in hospitals with necessary experience, can be proposed to selected patients who are informed of the risk of complications.
Mereu
Liliana
L
Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Negrar-Verona, Italy. liliana_mereu@yahoo.com
Ruffo
Giacomo
G
Landi
Stefano
S
Barbieri
Fabrizio
F
Zaccoletti
Riccardo
R
Fiaccavento
Andrea
A
Stepniewska
Ania
A
Pontrelli
Giovanni
G
Minelli
Luca
L
D000328:Adult; D003082:Colectomy / Q000706:statistics & numerical data; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000706:statistics & numerical data; D009017:Morbidity; D011446:Prospective Studies; D012002:Rectal Diseases / Q000209:etiology / Q000601:surgery*; D012720:Severity of Illness Index; D012810:Sigmoid Diseases / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome