Choosing the right technique for deep endometriosis

Publication date: Available online 29 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Michelle Nisolle, Géraldine Brichant, Linda TebacheAbstractThe surgical management of bowel endometriosis is a real challenge. Besides that only symptomatic patients should undergo surgery, no consensus has been approved in the literature.Among the surgical techniques, the surgeon has to choose between rectal shaving, disc excision or segmental colorectal resection. All those procedures are associated with complications but the risk of rectovaginal fistula is higher if a disc excision or segmental colorectal resection are performed. It is therefore of the utmost importance to evaluate preoperatively the bowel infiltration, by using several imaging techniques, in order to estimate the feasibility of a deep rectal shaving with possible incomplete removal of the endometriotic lesions or to discuss with the patient about the indication of a segmental bowel resection. Due to the risk of major per-operative and post-operative complications, proper patient counseling is mandatory.

Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 30, 2019 Category: OBGYN Source Type: research