title: Long-term follow-up and recurrence rate after mesorectum-sparing bowel resection among women with rectovaginal endometriosis.
abstract: OBJECTIVE
  To demonstrate the quality of a combined vaginal-abdominal surgical approach to rectovaginal endometriosis by analyzing long-term outcome and recurrence rates.
  
  
  METHODS
  In a prospective cohort study in Berlin, Germany, women with endometriosis of the rectovaginal septum were enrolled between September 2004 and December 2012. Bowel infiltration was verified intraoperatively and treated by a nerve-sparing, mesentery-preserving vaginal-abdominal operative approach. Operative results were evaluated by assessing short- and long-term complications and recurrence rates.
  
  
  RESULTS
  During the study period, 110 women underwent surgery. For 71 (64.5%) patients, bowel infiltration was confirmed intraoperatively. Overall, 15% of the patients had peri- or postoperative complications. No long-term complications occurred. After a median follow-up of 64 months, no recurrence in the rectovaginal septum was observed among the study patients. The recurrence of pelvic endometriosis was 15%.
  
  
  CONCLUSIONS
  The surgical nerve-sparing approach to rectovaginal endometriosis was confirmed to facilitate precise diagnosis and treatment with minimal morbidity and a long-term complication rate of 0%.
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany. Electronic address: mandy.mangler@charite.de.
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Herbstleb
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Mechsner
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Bartley
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Department of Gynecology, Charité Campus Mitte, Berlin, Germany.
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
mesh_terms: D000328:Adult; D001604:Berlin; D015331:Cohort Studies; D004715:Endometriosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012002:Rectal Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Bowel endometriosis; Histopathology in endometriosis; Nerve-sparing operative therapy in endometriosis; Rectovaginal endometriosis