title: Laparoscopic management of bowel endometriosis: resection margins as a predictor of recurrence.
abstract: OBJECTIVE
  To evaluate possible predictive factors for recurrence after laparoscopic segmental bowel resection for bowel endometriosis.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  95 symptomatic women with bowel endometriosis who underwent laparoscopic segmental bowel resection at the Endometriosis clinic, University of Berne, between 2002 and 2012 were enrolled. Since 14 women were lost to follow-up, 81 formed the final cohort. Clinical and histological characteristics were examined as possible predictive factors for disease recurrence.
  
  
  METHODS
  Recurrence, defined as a subsequent operation due to recurrent endometriosis-associated pain with a histologically confirmed endometriotic lesion.
  
  
  RESULTS
  Recurrence was observed in 13 (16%) patients. Variables that were significantly associated to recurrence by the Cox regression analysis were positive bowel resection margins (hazard ratio 6.5, 95% confidence interval 1.8-23.5, p = 0.005), age <31 years (hazard ratio 5.6, 95% confidence interval 1.7-18.6, p = 0.005) and body mass index ≥23 kg/m(2) (hazard ratio 11.0, 95% confidence interval 2.7-44.6, p = 0.001).
  
  
  CONCLUSIONS
  Positive bowel resection margins as well as age <31 years and body mass index ≥23 kg/m(2) appear to be independent predictors of disease recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, University of Berne, Berne, Switzerland.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Nirgianakis
authors.forename: Brett
authors.initials: B
authors.lastname: McKinnon
authors.forename: Sara
authors.initials: S
authors.lastname: Imboden
authors.forename: Laura
authors.initials: L
authors.lastname: Knabben
authors.forename: Beat
authors.initials: B
authors.lastname: Gloor
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
mesh_terms: D000328:Adult; D000367:Age Factors; D003108:Colonic Diseases / Q000473:pathology / Q000601:surgery*; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009664:Norway; D011379:Prognosis; D011788:Quality of Life; D012002:Rectal Diseases / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016387:Women's Health
keywords: Bowel endometriosis; recurrence; resection margins; segmental resection