title: Laparoscopic rectal resection of deep infiltrating endometriosis.
abstract: OBJECTIVE
  Deep infiltrating endometriosis with colorectal involvement is a complex disorder, often requiring segmental bowel resection. Complete removal of all visible lesions is considered the adequate treatment of infiltrating endometriosis in order to reduce recurrence. In this article, we describe our experience with laparoscopic management of deep infiltrating endometriosis with involvement of the rectum.
  
  
  METHODS
  A retrospective analysis of data from patients with deep infiltrating endometriosis with rectal involvement who underwent a laparoscopic surgery in the years 2002-2009 at the Department of Obstetrics and Gynecology at our institution was done.
  
  
  RESULTS
  Between 2002 and 2009, a laparoscopic partial rectal resection was performed in 52 patients, and laparoscopic disk resection was performed in 4 cases with deep infiltrating endometriosis. The mean age of patients was 34.4 years (range, 22-62 years). Preoperative symptoms included dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. The laparoscopic procedure was converted to formal laparotomy in 3 patients (5.4%). The mean duration of surgery was 145 minutes. Postoperative complications included 3 cases of anastomotic leakage with rectovaginal fistula in two cases and intraabdominal bleeding in 1 case. The mean hospital stay was 7 days. Postoperatively, nine patients had a normal delivery, two of them after in vitro fertilization treatment.
  
  
  CONCLUSIONS
  Laparoscopic rectal resection for deep infiltrating endometriosis is a relatively safe procedure, when performed by a surgeon and a gynecologist with sufficient experience in laparoscopic colorectal surgery.
authors.affiliation: Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia. franc.jelenc@kclj.si
authors.forename: Franc
authors.initials: F
authors.lastname: Jelenc
authors.forename: Martina
authors.initials: M
authors.lastname: Ribič-Pucelj
authors.forename: Robert
authors.initials: R
authors.lastname: Juvan
authors.forename: Borut
authors.initials: B
authors.lastname: Kobal
authors.forename: Jasna
authors.initials: J
authors.lastname: Sinkovec
authors.forename: Vesna
authors.initials: V
authors.lastname: Salamun
mesh_terms: D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012002:Rectal Diseases / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies