title: Is ileostomy always necessary following rectal resection for deep infiltrating endometriosis?
abstract: OBJECTIVE
  To verify the hypothesis that in most patients bowel segmental resection to treat endometriosis can be safely performed without creation of a stoma and to discuss the limitations of this statement.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification III).
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Forty-one women with sigmoid and rectal endometriotic lesions who underwent segmental resection.
  
  
  METHODS
  Segmental resection procedures performed between 2004 and 2011. Patient demographic, operative, and postoperative data were compared.
  
  
  RESULTS
  Sigmoid resection was performed in 6 patients (15%), and rectal anterior resection in 35 patients (high in 21 patients [51%], and low, i.e., <10 cm from the anal verge, in 14 [34%]). In 4 patients a temporary ileostomy was created. There was 1 anastomotic leak (2.4%), in a patient with an unprotected anastomosis, which was treated via laparoscopic surgery and creation of a temporary ileostomy. Other postoperative complications included hemoperitoneum, pelvic abscess, pelvic collection, and a ureteral vaginal fistula, in 1 patient each (all 2.4%).
  
  
  CONCLUSIONS
  A protective stoma may be averted in low anastomosis if it is >5 cm from the anal verge and there are no adverse intraoperative events.
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France. Electronic address: cherif.youssef2@wanadoo.fr.
authors.forename: Cherif
authors.initials: C
authors.lastname: Akladios
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Pietro
authors.initials: P
authors.lastname: Messori
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Faller
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Marco
authors.initials: M
authors.lastname: Puga
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Karolina
authors.initials: K
authors.lastname: Afors
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Joel
authors.initials: J
authors.lastname: Leroy
authors.affiliation: Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Wattiez
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000453:epidemiology; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*; D055815:Young Adult
keywords: Anastomotic leak; Bowel endometriosis; Colorectal resection; Ileostomy