title: Full-Thickness Excision versus Shaving by Laparoscopy for Intestinal Deep Infiltrating Endometriosis: Rationale and Potential Treatment Options.
abstract: Endometriosis is defined as the presence of endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. Deep infiltrating endometriosis (DIE) is considered the most aggressive presentation of the disease, penetrating more than 5 mm in affected tissues, and it is reported in approximately 20% of all women with endometriosis. DIE can cause a complete distortion of the pelvic anatomy and it mainly involves uterosacral ligaments, bladder, rectovaginal septum, rectum, and rectosigmoid colon. This review describes the state of the art in laparoscopic approach for DIE with a special interest in intestinal involvement, according to recent literature findings. Our attention has been focused particularly on full-thickness excision versus shaving technique in deep endometriosis intestinal involvement. Particularly, the aim of this paper is clarifying from the clinical and methodological points of view the best surgical treatment of deep intestinal endometriosis, since there is no standard of care in the literature and in different surgical settings. Indeed, this review tries to suggest when it is advisable to manage the full-thickness excision or the shaving technique, also analyzing perioperative management, main complications, and surgical outcomes.
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Antonio Simone
authors: 0000-0003-1543-2802
authors: AS
authors: Laganà
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Salvatore Giovanni
authors: 0000-0001-6871-6097
authors: SG
authors: Vitale
authors: Department of General Surgery and Medical Surgical Specialties, University of Catania, 95125 Catania, Italy.
authors: Maria Antonietta
authors: MA
authors: Trovato
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Vittorio Italo
authors: VI
authors: Palmara
authors: Department of General Surgery and Medical Surgical Specialties, University of Catania, 95125 Catania, Italy.
authors: Agnese Maria Chiara
authors: AM
authors: Rapisarda
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Roberta
authors: 0000-0003-0318-9390
authors: R
authors: Granese
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Emanuele
authors: E
authors: Sturlese
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Rosanna
authors: R
authors: De Dominici
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Stefano
authors: S
authors: Alecci
authors: Department of Gynecologic Ultrasound Imaging, Altamedica Fetal Maternal Medical Centre, 00198 Rome, Italy.
authors: Francesco
authors: 0000-0003-0376-9926
authors: F
authors: Padula
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Benito
authors: 0000-0003-2801-2962
authors: B
authors: Chiofalo
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Roberta
authors: 0000-0003-1417-5066
authors: R
authors: Grasso
authors: Department of Gynecologic Ultrasound Imaging, Altamedica Fetal Maternal Medical Centre, 00198 Rome, Italy.
authors: Pietro
authors: 0000-0002-6601-3782
authors: P
authors: Cignini
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Paolo
authors: P
authors: D'Amico
authors: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
authors: Onofrio
authors: O
authors: Triolo
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*