Laparoscopic ileocecal resection for bowel endometriosis.
BACKGROUND
Ileocecal endometriosis is a very rare entity, and its diagnosis is usually made during surgery for other endometriosis sites or, rarely, because of direct complications of ileal involvement. This study was designed to analyze perioperative and long-term outcomes after bowel resection for ileocecal endometriosis.


METHODS
All patients who underwent surgery for ileocecal endometriosis between October 2004 and January 2008 were prospectively collected and analyzed.


RESULTS
Thirty-one women (median age, 34 (range, 25-40) years) were identified. Ileocecal endometriosis was diagnosed during surgery in all patients, and it was associated with colorectal endometriosis in 29 patients (94%). All patients underwent laparoscopic ileocecal resection with no laparotomic conversion. Rectosigmoid or rectal resections was associated in 28 patients (90%) and nodulectomy for sigmoid endometriosis in 1 patient. Median duration of surgery was 301 (range, 90-480) min. Other associated surgical procedures included total hysterectomy (n = 3, 14%), ureterolysis (n = 7, 23%), excision of vesical (n = 4, 13%), vaginal (n = 8, 26%), and parametrial (n = 3, 14%) nodules. There was no mortality. Four patients (13%) required blood transfusions and one a reoperation for bleeding. In a patient who performed ureterolysis, a ureteral fistula occurred. The median hospital stay was 7 (range, 5-18) days. Long-term (>12 months) follow-up data were available for 18 patients. After a median follow-up of 27 months, in 12 of 18 patients (67%) defecation after surgery was normal. Only one patient developed recurrence, which is under medical treatment.


CONCLUSIONS
Laparoscopic ileocecal resection is safe and feasible and should be considered as part of surgery for endometriosis with radical intent.
Ruffo
Giacomo
G
Department of Surgery, Ospedale Sacro Cuore, Via Sempreboni, 5, 37024 Negrar, VR, Italy. giacomo.ruffo@sacrocuore.it
Stepniewska
Ania
A
Crippa
Stefano
S
Serboli
Giacomo
G
Zardini
Claudio
C
Steinkasserer
Martin
M
Ceccaroni
Marcello
M
Minelli
Luca
L
Falconi
Massimo
M
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002429:Cecal Diseases / Q000175:diagnosis / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007077:Ileal Diseases / Q000175:diagnosis / Q000601:surgery*; D033162:Incidental Findings; D010535:Laparoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery; D012008:Recurrence; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000601:surgery; D014623:Vaginal Diseases / Q000601:surgery