Clinical outcome after laparoscopic radical excision of endometriosis and laparoscopic segmental bowel resection.
OBJECTIVE
To present the clinical outcome after laparoscopic radical excision of deeply infiltrative endometriosis (DIE) with colorectal extension and laparoscopic segmental bowel resection.


RESULTS
In three different studies including mostly patients with recurrent DIE with colorectal extension, we showed that radical reconstructive CO2 laser laparoscopic resection of DIE with colorectal extension in a multidisciplinary setting resulted in a low complication rate, a low cumulative reintervention and recurrence rate and a high cumulative pregnancy rate, also when bowel resection reanastomosis was performed. In a systematic review to assess the clinical outcome of surgical treatment of DIE with colorectal involvement, data were reported in such a way that comparison of different surgical techniques was not possible. A checklist is proposed to achieve standardized reporting of presenting symptoms, preoperative tests, inclusion criteria, preoperative and postoperative care, complications, follow-up, patient-centered assessment of pain and quality of life, fertility and recurrence corrected for postoperative use of hormonal suppression or infertility treatment.


CONCLUSIONS
CO2 laser laparoscopic radical excision of DIE with colorectal extension and laparoscopic segmental bowel resection in centers of expertise is associated with good clinical outcome. To make real progress, international agreement is needed on terms and definitions used in surgical endometriosis research.
Leuven University Fertility Center, Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium.
Christel
C
Meuleman
Carla
C
Tomassetti
Thomas M
TM
D'Hooghe
D000328:Adult; D057189:Checklist; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D010535:Laparoscopy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D011788:Quality of Life; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult