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Surgery for gastrointestinal endometriosis : indications and results

PHILIPPE HOUTMEYERS (UGent) , Wim Ceelen (UGent) , Jean-Pierre Gillardin (UGent) , M Dhondt and Piet Pattyn (UGent)
(2006) ACTA CHIRURGICA BELGICA. 106(4). p.413-416
Author
Organization
Abstract
Background: Although gastrointestinal endometriosis is an uncommon and often unexpected finding, the best treatment requires removal of all endometriotic lesions. The purpose of our study was to report our experience with the diagnosis and treatment of bowel endometriosis. Material and Methods : From January 1997 to January 2004, 13 patients (mean 35.7y; range 21-55y) were operated for bowel endometriosis. We noted : age, history of endometriosis, previous pregnancies, preoperative investigations and symptoms, operative procedure and intraoperative findings. Follow-up varied between one month postoperative examination and seven years. Results : Presenting symptoms of the cases were : acute appendicitis (3), dysmenorrhoea (7), constipation (6), pelvic pain (2), rectal bleeding (3) and dyspareunia (2). Operative management was performed in accordance with the anatomical distribution. Seven patients had a history of previous operations and multifocal involvement was present in 61.5% of cases. At a median follow-up of 12.2 months, 83.3% had complete relief of their initial complaints, with only one reoperation needed. The pregnancy rate after surgery was 66.6%. Preoperative tests were : ultrasound for ovarian endometriomas, coloscopy, barium enema, vaginal palpation for detecting rectovaginal involvement, MRI and CT scan. These tests predicted the extension of endometriotic process correctly in 50% of the cases. Conclusions : Endometriosis of the sigmoid and rectum is rare but can give rise to severe gastrointestinal and pelvic symptoms. Preoperative investigations are not infallible in predicting the extent of the disease, sometimes placing the surgeon before a dilemma, because it involves mostly young women in the reproductive phase of life. The colorectal surgeon, therefore, should seek the advice of an experienced gynaecologist and vice versa. Removal of all endometriotic lesions is mandatory for obtaining an optimal relief of symptoms.
Keywords
gastro intestinal tract, TERM FOLLOW-UP, DEEP ENDOMETRIOSIS, SURGICAL-TREATMENT, RESECTION, endometriosis, PAIN, PELVIC ENDOMETRIOSIS, LAPAROSCOPIC TREATMENT

Citation

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MLA
HOUTMEYERS, PHILIPPE, Wim Ceelen, Jean-Pierre Gillardin, et al. “Surgery for Gastrointestinal Endometriosis : Indications and Results.” ACTA CHIRURGICA BELGICA 106.4 (2006): 413–416. Print.
APA
HOUTMEYERS, P., Ceelen, W., Gillardin, J.-P., Dhondt, M., & Pattyn, P. (2006). Surgery for gastrointestinal endometriosis : indications and results. ACTA CHIRURGICA BELGICA, 106(4), 413–416.
Chicago author-date
HOUTMEYERS, PHILIPPE, Wim Ceelen, Jean-Pierre Gillardin, M Dhondt, and Piet Pattyn. 2006. “Surgery for Gastrointestinal Endometriosis : Indications and Results.” Acta Chirurgica Belgica 106 (4): 413–416.
Chicago author-date (all authors)
HOUTMEYERS, PHILIPPE, Wim Ceelen, Jean-Pierre Gillardin, M Dhondt, and Piet Pattyn. 2006. “Surgery for Gastrointestinal Endometriosis : Indications and Results.” Acta Chirurgica Belgica 106 (4): 413–416.
Vancouver
1.
HOUTMEYERS P, Ceelen W, Gillardin J-P, Dhondt M, Pattyn P. Surgery for gastrointestinal endometriosis : indications and results. ACTA CHIRURGICA BELGICA. 2006;106(4):413–6.
IEEE
[1]
P. HOUTMEYERS, W. Ceelen, J.-P. Gillardin, M. Dhondt, and P. Pattyn, “Surgery for gastrointestinal endometriosis : indications and results,” ACTA CHIRURGICA BELGICA, vol. 106, no. 4, pp. 413–416, 2006.
@article{355168,
  abstract     = {Background: Although gastrointestinal endometriosis is an uncommon and often unexpected finding, the best treatment requires removal of all endometriotic lesions. The purpose of our study was to report our experience with the diagnosis and treatment of bowel endometriosis.
Material and Methods : From January 1997 to January 2004, 13 patients (mean 35.7y; range 21-55y) were operated for bowel endometriosis. We noted : age, history of endometriosis, previous pregnancies, preoperative investigations and symptoms, operative procedure and intraoperative findings. Follow-up varied between one month postoperative examination and seven years.
Results : Presenting symptoms of the cases were : acute appendicitis (3), dysmenorrhoea (7), constipation (6), pelvic pain (2), rectal bleeding (3) and dyspareunia (2). Operative management was performed in accordance with the anatomical distribution. Seven patients had a history of previous operations and multifocal involvement was present in 61.5% of cases. At a median follow-up of 12.2 months, 83.3% had complete relief of their initial complaints, with only one reoperation needed. The pregnancy rate after surgery was 66.6%. Preoperative tests were : ultrasound for ovarian endometriomas, coloscopy, barium enema, vaginal palpation for detecting rectovaginal involvement, MRI and CT scan. These tests predicted the extension of endometriotic process correctly in 50% of the cases.
Conclusions : Endometriosis of the sigmoid and rectum is rare but can give rise to severe gastrointestinal and pelvic symptoms. Preoperative investigations are not infallible in predicting the extent of the disease, sometimes placing the surgeon before a dilemma, because it involves mostly young women in the reproductive phase of life. The colorectal surgeon, therefore, should seek the advice of an experienced gynaecologist and vice versa. Removal of all endometriotic lesions is mandatory for obtaining an optimal relief of symptoms.},
  author       = {HOUTMEYERS, PHILIPPE and Ceelen, Wim and Gillardin, Jean-Pierre and Dhondt, M and Pattyn, Piet},
  issn         = {0001-5458},
  journal      = {ACTA CHIRURGICA BELGICA},
  keywords     = {gastro intestinal tract,TERM FOLLOW-UP,DEEP ENDOMETRIOSIS,SURGICAL-TREATMENT,RESECTION,endometriosis,PAIN,PELVIC ENDOMETRIOSIS,LAPAROSCOPIC TREATMENT},
  language     = {eng},
  number       = {4},
  pages        = {413--416},
  title        = {Surgery for gastrointestinal endometriosis : indications and results},
  volume       = {106},
  year         = {2006},
}

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