Complete Surgery for Low Rectal Endometriosis: Long-term Results of a 100-Case Prospective Study
We conducted a prospective study to assess the long-term results of complete surgery for low rectal endometriosis (LRE), paying particular attention to surgical complications, functional results, and disease recurrence after a follow-up of at least 5 years. Deep infiltrating endometriosis (DIE) may...
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| Veröffentlicht in: | Annals of surgery 2010-05, Vol.251 (5), p.887-895 |
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| creator | DOUSSET, Bertrand LECONTE, Mahaut BORGHESE, Bruno MILLISCHER, Anne-Elodie ROSEAU, Gilles ARKWRIGHT, Sylviane CHAPRON, Charles |
| description | We conducted a prospective study to assess the long-term results of complete surgery for low rectal endometriosis (LRE), paying particular attention to surgical complications, functional results, and disease recurrence after a follow-up of at least 5 years.
Deep infiltrating endometriosis (DIE) may infiltrate the midlow rectum and lead to severe pelvic pain. Complete resection of LRE is reluctantly considered by young women of childbearing age.
From 1995 to 2003, 100 women with severe pelvic pain and previous incomplete surgery (n=82) underwent complete open surgery for LRE after thorough preoperative imaging work-up. This included total or subtotal rectal excision with combined resection of all extrarectal endometriotic lesions. Univariate analysis of predictive factors for transient neurogenic bladder and surgical complications was performed. Mean follow-up was 78+/-15 months.
All patients underwent rectal resection with straight coloanal (n=16) or low colorectal anastomosis (n=84). A concomitant extrarectal procedure was required in all instances, including gynecologic procedures (n=100), additional intestinal (n=45), and urologic (n=23) resections. A fertility-preserving procedure was possible in 92% of the patients. Mean numbers of DIE and endometriotic lesions were 3.9+/-1.4 and 5.5+/-1.6 per patient, respectively. There were no deaths and the surgical morbidity rate was 16%. Sixteen patients developed a transient peripheral neurogenic bladder, which was more frequently observed after colonanal anastomosis (P |
| doi_str_mv | 10.1097/SLA.0b013e3181d9722d |
| format | Article |
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Deep infiltrating endometriosis (DIE) may infiltrate the midlow rectum and lead to severe pelvic pain. Complete resection of LRE is reluctantly considered by young women of childbearing age.
From 1995 to 2003, 100 women with severe pelvic pain and previous incomplete surgery (n=82) underwent complete open surgery for LRE after thorough preoperative imaging work-up. This included total or subtotal rectal excision with combined resection of all extrarectal endometriotic lesions. Univariate analysis of predictive factors for transient neurogenic bladder and surgical complications was performed. Mean follow-up was 78+/-15 months.
All patients underwent rectal resection with straight coloanal (n=16) or low colorectal anastomosis (n=84). A concomitant extrarectal procedure was required in all instances, including gynecologic procedures (n=100), additional intestinal (n=45), and urologic (n=23) resections. A fertility-preserving procedure was possible in 92% of the patients. Mean numbers of DIE and endometriotic lesions were 3.9+/-1.4 and 5.5+/-1.6 per patient, respectively. There were no deaths and the surgical morbidity rate was 16%. Sixteen patients developed a transient peripheral neurogenic bladder, which was more frequently observed after colonanal anastomosis (P<0.001) or concomitant hysterectomy (P<0.01) and in patients with more than 4 DIE lesions (P<0.05). At last follow-up, 94 patients had complete (n=83) or very satisfactory (n=11) relief of symptoms. Urine voiding and fecal continence was satisfactory in all cases. There was no recurrence of colorectal and/or urologic endometriosis and the overall DIE recurrence rate was 2%.
Complete surgery for LRE provides excellent long-term functional results in 94% of the patients, provided all extraintestinal endometriotic lesions are resected during the same surgical procedure. In that setting, the overall 5-year recurrence rate is very low.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0b013e3181d9722d</identifier><identifier>PMID: 20395847</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Biological and medical sciences ; Digestive System Surgical Procedures ; Endometriosis - diagnostic imaging ; Endometriosis - surgery ; Female ; Female genital diseases ; General aspects ; Gynecology. Andrology. Obstetrics ; Humans ; Ileostomy ; Medical sciences ; Middle Aged ; Non tumoral diseases ; Postoperative Complications - epidemiology ; Prospective Studies ; Radiography ; Rectal Diseases - diagnostic imaging ; Rectal Diseases - surgery ; Recurrence ; Treatment Outcome ; Young Adult</subject><ispartof>Annals of surgery, 2010-05, Vol.251 (5), p.887-895</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c285t-a201ebad54422dfeb4cbd4077678fd4b4f3e4b3cc3630f7e938f18165be810d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22700882$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20395847$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DOUSSET, Bertrand</creatorcontrib><creatorcontrib>LECONTE, Mahaut</creatorcontrib><creatorcontrib>BORGHESE, Bruno</creatorcontrib><creatorcontrib>MILLISCHER, Anne-Elodie</creatorcontrib><creatorcontrib>ROSEAU, Gilles</creatorcontrib><creatorcontrib>ARKWRIGHT, Sylviane</creatorcontrib><creatorcontrib>CHAPRON, Charles</creatorcontrib><title>Complete Surgery for Low Rectal Endometriosis: Long-term Results of a 100-Case Prospective Study</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>We conducted a prospective study to assess the long-term results of complete surgery for low rectal endometriosis (LRE), paying particular attention to surgical complications, functional results, and disease recurrence after a follow-up of at least 5 years.
Deep infiltrating endometriosis (DIE) may infiltrate the midlow rectum and lead to severe pelvic pain. Complete resection of LRE is reluctantly considered by young women of childbearing age.
From 1995 to 2003, 100 women with severe pelvic pain and previous incomplete surgery (n=82) underwent complete open surgery for LRE after thorough preoperative imaging work-up. This included total or subtotal rectal excision with combined resection of all extrarectal endometriotic lesions. Univariate analysis of predictive factors for transient neurogenic bladder and surgical complications was performed. Mean follow-up was 78+/-15 months.
All patients underwent rectal resection with straight coloanal (n=16) or low colorectal anastomosis (n=84). A concomitant extrarectal procedure was required in all instances, including gynecologic procedures (n=100), additional intestinal (n=45), and urologic (n=23) resections. A fertility-preserving procedure was possible in 92% of the patients. Mean numbers of DIE and endometriotic lesions were 3.9+/-1.4 and 5.5+/-1.6 per patient, respectively. There were no deaths and the surgical morbidity rate was 16%. Sixteen patients developed a transient peripheral neurogenic bladder, which was more frequently observed after colonanal anastomosis (P<0.001) or concomitant hysterectomy (P<0.01) and in patients with more than 4 DIE lesions (P<0.05). At last follow-up, 94 patients had complete (n=83) or very satisfactory (n=11) relief of symptoms. Urine voiding and fecal continence was satisfactory in all cases. There was no recurrence of colorectal and/or urologic endometriosis and the overall DIE recurrence rate was 2%.
Complete surgery for LRE provides excellent long-term functional results in 94% of the patients, provided all extraintestinal endometriotic lesions are resected during the same surgical procedure. In that setting, the overall 5-year recurrence rate is very low.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Digestive System Surgical Procedures</subject><subject>Endometriosis - diagnostic imaging</subject><subject>Endometriosis - surgery</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>General aspects</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Ileostomy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Rectal Diseases - diagnostic imaging</subject><subject>Rectal Diseases - surgery</subject><subject>Recurrence</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE9PGzEQxa0KRELgG1TIF9TThvGfjb3cUERLpUigBs6L1x5HW-3Gwd4tyrevq6RF6mkO83tv5j1CPjOYM6jUzXp1N4cGmEDBNHOV4tx9IlNWcl0wJuGETAFAFLISfELOU_oJwKQGdUYmHERVaqmm5HUZ-l2HA9L1GDcY99SHSFfhnf5AO5iO3m9d6HGIbUhtus2b7aYYMPZ5n8ZuSDR4aigDKJYmIX2KIe2ysv2VHYfR7S_IqTddwsvjnJGXr_fPy4di9fjt-_JuVViuy6EwHBg2xpVS5hweG2kbJ0GphdLeyUZ6gbIR1oqFAK-wEtrn2IuyQc3AKTEjXw6-uxjeRkxD3bfJYteZLYYx1UqIkpWwkJmUB9LmX1NEX-9i25u4rxnUf6qtc7X1_9Vm2dXxwNj06P6J_naZgesjYJI1nY9ma9v0wXEFoDUXvwERzYJA</recordid><startdate>20100501</startdate><enddate>20100501</enddate><creator>DOUSSET, Bertrand</creator><creator>LECONTE, Mahaut</creator><creator>BORGHESE, Bruno</creator><creator>MILLISCHER, Anne-Elodie</creator><creator>ROSEAU, Gilles</creator><creator>ARKWRIGHT, Sylviane</creator><creator>CHAPRON, Charles</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100501</creationdate><title>Complete Surgery for Low Rectal Endometriosis: Long-term Results of a 100-Case Prospective Study</title><author>DOUSSET, Bertrand ; LECONTE, Mahaut ; BORGHESE, Bruno ; MILLISCHER, Anne-Elodie ; ROSEAU, Gilles ; ARKWRIGHT, Sylviane ; CHAPRON, Charles</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c285t-a201ebad54422dfeb4cbd4077678fd4b4f3e4b3cc3630f7e938f18165be810d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Digestive System Surgical Procedures</topic><topic>Endometriosis - diagnostic imaging</topic><topic>Endometriosis - surgery</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>General aspects</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Ileostomy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Rectal Diseases - diagnostic imaging</topic><topic>Rectal Diseases - surgery</topic><topic>Recurrence</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DOUSSET, Bertrand</creatorcontrib><creatorcontrib>LECONTE, Mahaut</creatorcontrib><creatorcontrib>BORGHESE, Bruno</creatorcontrib><creatorcontrib>MILLISCHER, Anne-Elodie</creatorcontrib><creatorcontrib>ROSEAU, Gilles</creatorcontrib><creatorcontrib>ARKWRIGHT, Sylviane</creatorcontrib><creatorcontrib>CHAPRON, Charles</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DOUSSET, Bertrand</au><au>LECONTE, Mahaut</au><au>BORGHESE, Bruno</au><au>MILLISCHER, Anne-Elodie</au><au>ROSEAU, Gilles</au><au>ARKWRIGHT, Sylviane</au><au>CHAPRON, Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complete Surgery for Low Rectal Endometriosis: Long-term Results of a 100-Case Prospective Study</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2010-05-01</date><risdate>2010</risdate><volume>251</volume><issue>5</issue><spage>887</spage><epage>895</epage><pages>887-895</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>We conducted a prospective study to assess the long-term results of complete surgery for low rectal endometriosis (LRE), paying particular attention to surgical complications, functional results, and disease recurrence after a follow-up of at least 5 years.
Deep infiltrating endometriosis (DIE) may infiltrate the midlow rectum and lead to severe pelvic pain. Complete resection of LRE is reluctantly considered by young women of childbearing age.
From 1995 to 2003, 100 women with severe pelvic pain and previous incomplete surgery (n=82) underwent complete open surgery for LRE after thorough preoperative imaging work-up. This included total or subtotal rectal excision with combined resection of all extrarectal endometriotic lesions. Univariate analysis of predictive factors for transient neurogenic bladder and surgical complications was performed. Mean follow-up was 78+/-15 months.
All patients underwent rectal resection with straight coloanal (n=16) or low colorectal anastomosis (n=84). A concomitant extrarectal procedure was required in all instances, including gynecologic procedures (n=100), additional intestinal (n=45), and urologic (n=23) resections. A fertility-preserving procedure was possible in 92% of the patients. Mean numbers of DIE and endometriotic lesions were 3.9+/-1.4 and 5.5+/-1.6 per patient, respectively. There were no deaths and the surgical morbidity rate was 16%. Sixteen patients developed a transient peripheral neurogenic bladder, which was more frequently observed after colonanal anastomosis (P<0.001) or concomitant hysterectomy (P<0.01) and in patients with more than 4 DIE lesions (P<0.05). At last follow-up, 94 patients had complete (n=83) or very satisfactory (n=11) relief of symptoms. Urine voiding and fecal continence was satisfactory in all cases. There was no recurrence of colorectal and/or urologic endometriosis and the overall DIE recurrence rate was 2%.
Complete surgery for LRE provides excellent long-term functional results in 94% of the patients, provided all extraintestinal endometriotic lesions are resected during the same surgical procedure. In that setting, the overall 5-year recurrence rate is very low.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>20395847</pmid><doi>10.1097/SLA.0b013e3181d9722d</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Digestive System Surgical Procedures Endometriosis - diagnostic imaging Endometriosis - surgery Female Female genital diseases General aspects Gynecology. Andrology. Obstetrics Humans Ileostomy Medical sciences Middle Aged Non tumoral diseases Postoperative Complications - epidemiology Prospective Studies Radiography Rectal Diseases - diagnostic imaging Rectal Diseases - surgery Recurrence Treatment Outcome Young Adult |
| title | Complete Surgery for Low Rectal Endometriosis: Long-term Results of a 100-Case Prospective Study |
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