title: Role of protective defunctioning stoma in colorectal resection for endometriosis.
abstract: OBJECTIVE
  To evaluate the role of protective defunctioning stoma (PDS) on the occurrence of digestive tract complications after colorectal resection to treat endometriosis.
  
  
  METHODS
  Prospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  All patients undergoing segmental colorectal resection to treat colorectal endometriosis with and without PDS between 2003 and 2011 at Tenon University Hospital, Paris, France.
  
  
  RESULTS
  Patients were assessed at 1, 6, and 12 months postoperatively and each year thereafter. Median follow-up was 60 months. Of 198 patients included for analysis, 53 (27%) had PDS. Overall, 15 (7.5%) digestive tract complications occurred: 9 (4.5%) rectovaginal fistulas and 6 (3%) anastomotic leakages. All rectovaginal fistulas occurred in patients with a low colorectal anastomosis (p < .001) and 88% (8 of 9) in patients with a partial colpectomy (p < .001). PDS was associated with a decrease in the number of rectovaginal fistulas in women undergoing partial colpectomy and low colorectal resection from 27% to 15%, without reaching significance (p = .4). No anastomotic leakage occurred in patients with PDS.
  
  
  CONCLUSIONS
  Our results support that PDS can be omitted in patients with mid-colorectal anastomosis without partial colpectomy. In patients requiring partial colpectomy or partial colpectomy plus low colorectal anastomosis, PDS remains questionable.
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Belghiti
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Sonia
authors.initials: S
authors.lastname: Zilberman
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Thomin
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Zacharopoulou
authors.affiliation: Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bazot
authors.affiliation: Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.affiliation: Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France. Electronic address: emile.darai@tnn.aphp.fr.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000453:epidemiology*; D015331:Cohort Studies; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012006:Rectovaginal Fistula / Q000453:epidemiology*; D012007:Rectum / Q000601:surgery*; D054047:Surgical Stomas; D055815:Young Adult
keywords: Colorectal endometriosis; Digestive complication; Protective defunctioning stoma; Rectovaginal fistula