Major and minor complications after resection without bowel resection for deeply infiltrating endometriosis

2018 ◽  
Vol 298 (5) ◽  
pp. 991-999 ◽  
Author(s):  
Johannes Lermann ◽  
Nalan Topal ◽  
Werner Adler ◽  
Thomas Hildebrandt ◽  
Stefan P. Renner ◽  
...  
Keyword(s):  
Bowel Resection ◽  
Deeply Infiltrating Endometriosis ◽  
Infiltrating Endometriosis

scholarly journals Medical management of deeply infiltrating endometriosis - 7 year experience in a tertiary endometriosis centre in London

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Marianne Wild ◽  
Tariq Miskry ◽  
Asmaa Al-Kufaishi ◽  
Gillian Rose ◽  
Mary Crofton
Keyword(s):  
Medical Management ◽  
Obstructive Uropathy ◽  
Intrauterine Device ◽  
Secondary Analysis ◽  
Surgical Excision ◽  
Hormonal Contraceptive ◽  
Reproductive Age ◽  
Deeply Infiltrating Endometriosis ◽  
Hormonal Therapies ◽  
Infiltrating Endometriosis

Abstract Background Deeply infiltrating endometriosis has an estimated prevalence of 1% in women of reproductive age. Ninety percent have rectovaginal lesions but disease may also include the bowel, bladder and ureters. Current practice often favours minimally invasive surgical excision; however, there is increasing evidence that medical management can be as effective as long as obstructive uropathy and bowel stenosis are excluded. Our objective was to establish the proportion of women with deeply infiltrating endometriosis successfully managed with hormonal therapies within our tertiary endometriosis centre in West London. Secondary analysis was performed on anonymised data from the Trust’s endometriosis database. Results One hundred fifty-two women with deeply infiltrating endometriosis were discussed at our endometriosis multidisciplinary meeting between January 2010 and December 2016. Seventy-five percent of women underwent a trial of medical management. Of these, 44.7% did not require any surgical intervention during the study period, and 7.9% were symptomatically content but required interventions to optimise their fertility prospects. Another 7.0% were successfully medically managed for at least 12 months, but ultimately required surgery as their symptoms deteriorated. 26.5% took combined oral contraceptives, 14.7% oral progestogens, 1.5% progestogen implant, 13.2% levonorgestrel intrauterine device, 22.1% gonadotrophin-releasing hormone analogues, and 22.1% had analogues for 3–6 months then stepped down to another hormonal contraceptive. All women who underwent serial imaging demonstrated improvement or stable disease on MRI or ultrasound. Conclusions Medical treatments are generally safe, well tolerated and inexpensive. More than half (52.6%) of women were successfully managed with medical therapy to control their symptoms. This study supports the growing evidence supporting hormonal therapies in the management of deeply infiltrating endometriosis. The findings may be used to counsel women on the likely success rate of medical management.

Elevated Serum and Peritoneal Interleukin-33 Levels in Deeply Infiltrating Endometriosis

2012 ◽  
Vol 19 (6) ◽  
pp. S6-S7
Author(s):  
P. Santulli ◽  
B. Borghese ◽  
S. Chouzenoux ◽  
I. Streuli ◽  
D. de Ziegler ◽  
...  
Keyword(s):  
Elevated Serum ◽  
Interleukin 33 ◽  
Deeply Infiltrating Endometriosis ◽  
Infiltrating Endometriosis

scholarly journals Experience with multidisciplinary laparoscopic surgery in patients with deep infiltrating colorectal endometriosis

2014 ◽  
Vol 155 (5) ◽  
pp. 182-186 ◽  
Author(s):  
Attila Bokor ◽  
Réka Brubel ◽  
Péter Lukovich ◽  
János Rigó jr.
Keyword(s):  
Bowel Resection ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Sigmoid Resection ◽  
Deep Infiltrating Endometriosis ◽  
Colorectal Endometriosis ◽  
Segmental Bowel Resection ◽  
The Mean ◽  
Colorectal Resections ◽  
Infiltrating Endometriosis

Introduction: Deep infiltrating endometriosis is a particular form of endometriosis that penetrates the peritoneal surface or it reaches the subserosal neurovascular plexus. Aim: The aim of the authors was to analyze the results of segmental colorectal resections performed for deep infiltrating endometriosis. Method: Between 2009 and 2012, 50 patients underwent segmental rectum or/and sigmoid resection for endometriosis. Results: 21 patients had ultralow rectal resection and 29 patients had low colorectal anastomosis or anterior resection. Concomitant intervention in other organs was required in all cases, including gynecologic procedures (n = 50), additional gynecologic (n = 47), vesical (n = 9) and ureteral (n = 18) resections. The mean number of endometriosis lesions was 2.4±1.8 per patient. In all patients fertility was preserved. Severe surgical complications (Clavien–Dindo stage III or more severe) occurred in 3 patients (6%). Conclusions: The results confirm that segmental bowel resection is an efficient and safe method for the treatment of deep infiltrating colorectal endometriosis. Orv. Hetil., 2014, 155(5), 182–186.

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