title: Computed tomography-based virtual colonoscopy in the assessment of bowel endometriosis: The surgeon's point of view.
abstract: OBJECTIVE
  To discuss the role of computed tomography-based virtual colonoscopy (CTC) in preoperative assessment of bowel endometriosis.
  
  
  METHODS
  Retrospective study using data prospectively recorded, including 127 patients with colorectal endometriosis, having undergone CTC for bowel endometriosis. The study was conducted in a tertiary referral center during 38 consecutive months. Preoperative assessment included CTC, magnetic resonance imaging (MRI), endorectal ultrasound (ERUS) and clinical examination. Information concerning identification of deep infiltrating endometriosis (DIE) of the bowel, the length and height of colorectal involvement, stenosis of digestive lumen and associated digestive localizations were compared with intraoperative findings.
  
  
  RESULTS
  Sensitivity and specificity of CTC for DIE of the rectum, the sigmoid colon, associated digestive localizations, and stenosis of the digestive lumen were respectively 97% and 84%, 93% and 88%, 84% and 97%, 96% and 96%. Intraoperative estimation of the length of digestive tract involved by DIE was closer to that provided by CTC than those provided by MRI and ERUS. When CTC revealed stenosis of digestive lumen, higher rates of colorectal resection (63% vs. 9.6%, < 0.001) and disc excision (25.9% vs. 11%, 0.03) were recorded.
  
  
  CONCLUSIONS
  For those surgeons using various procedures for management of bowel endometriosis, accurate information on the length and height of bowel involvement, as well as the existence of bowel stenosis enables informed decision regarding the feasibility of conservative techniques versus bowel resection. Preoperative identification of associated localizations above the sigmoid colon is another major advantage related to CTC.
  
  
  CONCLUSIONS
  CTC provides accurate data on the length and height of colorectal involvement by DIE, stenosis of digestive lumen and associated lesions of digestive tract, which impact on the choice of surgical procedure.
authors.affiliation: Department of gynecology and obstetrics, Rouen university hospital-Charles Nicolle, 1, rue de Germont, 76031 Rouen, France; Research group 4308 "Spermatogenesis and Gamete Quality", IHU Rouen Normandy, IFRMP23, reproductive biology laboratory, Rouen university hospital, 76031 Rouen, France. Electronic address: horace.roman@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Roman
authors.affiliation: Department of gynecology and obstetrics, Rouen university hospital-Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: J
authors.initials: J
authors.lastname: Carilho
authors.affiliation: Department of radiology, Rouen university hospital, 76031 Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: Da Costa
authors.affiliation: Department of radiology, Rouen university hospital, 76031 Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: De Vecchi
authors.affiliation: Clinique de l'Europe, 76100 Rouen, France.
authors.forename: O
authors.initials: O
authors.lastname: Suaud
authors.affiliation: Clinique du Cèdre, 76230 Bois-Guillaume, France.
authors.forename: M
authors.initials: M
authors.lastname: Monroc
authors.affiliation: Clinique du Cèdre, 76230 Bois-Guillaume, France.
authors.forename: P
authors.initials: P
authors.lastname: Hochain
authors.affiliation: Department of gynecology and obstetrics, Rouen university hospital-Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Vassilieff
authors.affiliation: Department of radiology, Rouen university hospital, 76031 Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: Savoye-Collet
authors.affiliation: Department of gynecology and obstetrics, Rouen university hospital-Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Saint-Ghislain
mesh_terms: D003108:Colonic Diseases / Q000601:surgery; D023881:Colonography, Computed Tomographic / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care; D012002:Rectal Diseases / Q000601:surgery; D012680:Sensitivity and Specificity; D066231:Surgeons
keywords: Bowel endometriosis; Colorectal endometriosis; Coloscanner avec coloscopie virtuelle; Computed tomography-based virtual colonoscopy; Endometrioses colorectale; Endometrioses digestive; Endorectal ultrasound; Échographie endorectale