Abstract:

Rectosigmoid endometriosis is one of the most advanced forms of the disease affecting 3% to 37% of patients with endometriosis. Some patients are asymptomatic but others can develop severe symptoms such as abdominal and pelvic pain, diarrhea, constipation, and rectal bleeding. Transvaginal ultrasonography (USG-TV) with bowel preparation is the first-line investigation in patients with suspected bowel endometriosis and allows accurate determination of the presence of the disease. When endometriosis of rectosigmoid is diagnosed, the USG-TV helps the surgical team to define the appropriate therapeutic strategy, be it surgical or conservative. The surgical management of rectosigmoid endometriosis includes disc resection or segmental bowel resection. In recent years, disc resection has gained adherents; this approach allows the resection of macroscopic disease with fewer complications than segmental bowel resection. However, disc resection is only indicated when a lesion is unifocal, the size does not exceed 3 cm, and it does not involve more than 50% to 60% of circumference of the rectum or sigmoid wall. This article describes the laparoscopic disc resection surgical technique for intestinal deep endometriosis, its feasibility, and its current status.

Authors:

Amélia de Almeida, MD, Gynecologist, Department of Obstetrics and Gynecology, Centro Hospitalar Tâmega e Sousa, Penafiel-Porto, Portugal, Luiz F. Fernandes, MD, Gynecological Surgeon, Sirio Libanes Hospital, São Paulo, Brazil, Marcelo Averbach, MD, Colorectal Surgeon, Sirio Libanes Hospital, São Paulo, Brazil, Mauricio S. Abrão, MD, Gynecological Surgeon, Sirio Libanes Hospital, Associate Professor, Obstetrics and Gynecology Department, Sao Paulo University, Sao Paulo, Brazil

PMID:  24526427

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