Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case-control study.
OBJECTIVE
To evaluate the efficacy of discoid resection for the treatment of deep infiltrating endometriosis and whether it could be considered to be a valid alternative to the rectosigmoid segmental resection.


METHODS
Case-control study.


METHODS
Departments of Obstetrics and Gynecology, Ospedale Sacro Cuore of Negrar, Verona, and Catholic University of the Sacred Heart, Rome, Italy.


METHODS
Women with deep infiltrating and intestinal endometriosis divided into study group (48 patients) and control group (88 patients).


METHODS
All patients underwent laparoscopic endometriosis excision plus discoid rectosigmoid resection (study group) or segmental resection (control group).


METHODS
Short- and long-term outcomes.


RESULTS
In the study group, median operating time was 200 minutes, with a median estimated blood loss of 203 mL. Median ileus was 3 days with a median postoperative hospitalization of 7 days. Early complications were observed in six patients (12.5%), and in two of them (4.16%) a surgical management was necessary. Median follow-up period was 33 months, and five recurrences (10.4%) were registered. In the control group, no significant differences were noticed except for longer operative time, more temporary ileostomy, postoperative fever, and long-term bladder dysfunctions.


CONCLUSIONS
Laparoscopic mechanical discoid resection is feasible, markedly improved endometriosis related symptoms, and could be considered as a worthy alternative to classic segmental resection in selected patients.
Fanfani
Francesco
F
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. francesco.fanfani@rm.unicatt.it
Fagotti
Anna
A
Gagliardi
Maria Lucia
ML
Ruffo
Giacomo
G
Ceccaroni
Marcello
M
Scambia
Giovanni
G
Minelli
Luca
L
D000328:Adult; D000465:Algorithms; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery*; D012008:Recurrence; D012720:Severity of Illness Index; D012810:Sigmoid Diseases / Q000601:surgery*; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery; D055815:Young Adult