title: Feasibility and first long-term results after laparoscopic rectal segment resection and vaginal specimen retrieval for deep infiltrating endometriosis.
abstract: BACKGROUND
  Radical resection of deep infiltrating endometriosis (DIE), including bladder and bowel resection, provides relief from pain in symptomatic patients. The laparoscopic approach to treatment is well established for bowel resection but normally requires additional abdominal incisions for specimen retrieval. Here we describe our technique of laparoscopically assisted rectal resection and transvaginal specimen retrieval (LARRT) and provide follow-up information on pain scores and complications.
  
  
  METHODS
  Retrospective observational monocentric study on all DIE patients with rectal infiltration treated between 2008 and 2010 with LATRR at our department. Follow-up was obtained for at least 3 years, including baseline 1-year and 3-year pain scores.
  
  
  RESULTS
  We identified four patients undergoing LARRT available for follow-up. DIE was confirmed by histology in all cases. There were no intraoperative complications. Two patients had transient postoperative urinary retention, one patient developed recto-vaginal fistula and required transient colostomy. One patient suffered from persistent vaginal dryness. All patients, however, reported persistent pain relief, including at the end of follow-up period.
  
  
  CONCLUSIONS
  LARRT is a feasible variation of laparoscopic bowel resection for DIE with rectal infiltration. In our study it has promising results with respect to pain control. Larger studies will, however, be required to determine the safety of this procedure.
authors.affiliation: Department of Obstetrics and Gynecology, Heinrich-Heine-University Medical Centre, Moorenstr 5, 40225, Duesseldorf, Germany, Fleisch@uni-duesseldorf.de.
authors.forename: M C
authors.initials: MC
authors.lastname: Fleisch
authors.forename: P
authors.initials: P
authors.lastname: Hepp
authors.forename: T
authors.initials: T
authors.lastname: Kaleta
authors.forename: J
authors.initials: J
authors.lastname: Schulte Am Esch
authors.forename: D
authors.initials: D
authors.lastname: Rein
authors.forename: T
authors.initials: T
authors.lastname: Fehm
authors.forename: I
authors.initials: I
authors.lastname: Beyer
mesh_terms: D000328:Adult; D020884:Colpotomy; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008488:Medical Illustration; D010781:Photography; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*