title: Colorectal resection in deep pelvic endometriosis: Surgical technique and post-operative complications.
abstract: OBJECTIVE
  To investigate the impact of different surgical techniques on post-operative complications after colorectal resection for endometriosis.
  
  
  METHODS
  A multicenter case-controlled study using the prospectively collected data of 90 women (22 with and 68 without post-operative complications) who underwent laparoscopic colorectal resection for endometriosis was designed to evaluate any risk factors of post-operative complications. The prospectively collected data included: gender, age, body mass index, American Society of Anesthesiologists risk class, endometriosis localization (from anal verge), operative time, conversion, intraoperative complications, and post-operative surgical complications such as anastomotic dehiscence, bleeding, infection, and bowel dysfunction.
  
  
  RESULTS
  A similar number of complicated cases have been registered for the different surgical techniques evaluated (laparoscopy, single access, flexure mobilization, mesenteric artery ligation, and transvaginal specimen extraction). A multivariate regression analysis showed that, after adjusting for major clinical, demographic, and surgical characteristics, complicated cases were only associated with endometriosis localization from the anal verge (OR = 0.8, 95%CI: 0.74-0.98, P = 0.03). After analyzing the association of post-operative complications and each different surgical technique, we found that only bowel dysfunction after surgery was associated with mesenteric artery ligation (11 out of 44 dysfunctions in the mesenteric artery ligation group vs 2 out of 36 cases in the no mesenteric artery ligation group; P = 0.03).
  
  
  CONCLUSIONS
  Although further randomized clinical trials are needed to give a definitive conclusion, laparoscopic colorectal resection for deep infiltrating endometriosis appears to be both feasible and safe. Surgical technique cannot be considered a risk factor of post-operative complications.
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Milone
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vignali
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Milone
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Giusto
authors.initials: G
authors.lastname: Pignata
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Elmore
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Musella
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Placido
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mollo
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Loredana Maria Sosa
authors.initials: LM
authors.lastname: Fernandez
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Coretti
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Bracale
authors.affiliation: Marco Milone, Francesco Milone, Mario Musella, Giuseppe De Placido, Antonio Mollo, Loredana Maria Sosa Fernandez, Guido Coretti, Department of Advanced Biomedical Science, University of Naples "Federico II", 80131 Naples, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rosati
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003108:Colonic Diseases / Q000175:diagnosis / Q000601:surgery*; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008026:Ligation; D016014:Linear Models; D016015:Logistic Models; D008638:Mesenteric Arteries / Q000601:surgery*; D015999:Multivariate Analysis; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D020127:Recovery of Function; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bowel; Complication; Endometriosis; Laparoscopy; Mesenteric artery; Technique