Multidisciplinary laparoscopic treatment for bowel endometriosis.
Endometriosis is a handicapping disease affecting young females in the reproductive period. It mainly occurs in the pelvis and affects the bowel in 3-37%. Endometriosis can cause menstrual and non-menstrual pelvic pain and infertility. Colorectal involvement results in alterations of bowel habit such as constipation, diarrhoea, tenesmus, and rarely rectal bleeding. A precise diagnosis about the presence, location and extent is necessary. Based on clinical examination, the diagnosis of bowel endometriosis can be made by transvaginal ultrasound, barium enema examination and magnetic resonance imaging. Multidisciplinary laparoscopic treatment has become the standard of care and depending on size of the lesion and site of involvement full-thickness disc excision or bowel resection is performed by an experienced colorectal surgeon. Anastomotic complications occur around 1%. Long-term outcome after bowel resection for severe endometriosis is good with a pregnancy rate of 50%.
Department of Abdominal Surgery, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: albert.wolthuis@uzleuven.be.
Albert M
AM
Wolthuis
Leuven University Fertility Centre, Department of Obstetrics and Gynaecology, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium.
Carla
C
Tomassetti
D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D033183:Interdisciplinary Communication; D007410:Intestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards; D010348:Patient Care Team / Q000592:standards; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D018873:Pregnancy Rate; D020127:Recovery of Function; D059039:Standard of Care; D016896:Treatment Outcome
Colorectal endometriosis; Deeply infiltrative endometriosis; Diagnosis; Endometriosis; Laparoscopy; Treatment