Preoperative Ultrasound Indications Determine Excision Technique for Bowel Surgery for Deep Infiltrating Endometriosis: A Single, High Volume Center

Publication date: Available online 31 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Mario Malzoni, Lucia Casarella, Marina Coppola, Francesca Falcone, Domenico Iuzzolino, Marianna Rasile, Alessandra Di GiovanniABSTRACTStudy objectiveTo identify bowel nodule features of deep infiltrating endometriosis (DIE) measured via preoperative ultrasound (US) that influence laparoscopic surgical strategy.DesignA retrospective studySettingMalzoni Clinic – Endoscopica Malzoni Department, Center for Advanced Endoscopic Gynecological Surgery, Avellino - ItalyPatientsPatients undergoing laparoscopic surgery between January 1, 2014 and December 31, 2018 for clinically suspected DIE with previous US evaluation ≤ 1 month before intervention.InterventionUse of US measurements to determine laparoscopic excision technique (segmental bowel resection, discoid resection, shaving) for DIE with bowel involvement.Measurements and main resultsOf 5051 DIE surgeries, 4983 were included; 1494 (29.9%) bowel resections (512 bowel segmental resections and 982 nodulectomies [967 shaving and 15 discoid resections]) were performed, accounting for 34.3% and 65.7% of all bowel procedures, respectively. Preoperative US findings and surgical reports were collected. Sensitivity and specificity of preoperative ultrasound evaluation for all types of DIE lesions were calculated, and US measurements of bowel nodules and different surgical techniques were compared. According to US preoperat...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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Authors: Zhang X, He T, Shen W Abstract Visual inspection via laparoscopy is considered the gold standard for the diagnosis of deep infiltrating endometriosis. Laparoscopy is an invasive procedure; therefore, it would be beneficial to patients if accurate non-invasive modalities were available for the diagnosis of deep infiltrating endometriosis. The purpose of the current review and meta-analysis was to assess the diagnostic accuracy of clinical examination, transvaginal ultrasound (TVUS), transrectal ultrasound (TRUS) and MRI as alternative methods for diagnosis of deep infiltrating endometriosis. A systematic se...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Abstract We conducted a retrospective cohort study to investigate the risk of developing hyperlipidemia in women with endometriosis and hormone therapy using claims data from the universal health insurance of Taiwan. We selected 9,155 women aged 20-55 years with endometriosis diagnosed from 2000-2013 and 212,641 women without endometriosis with median follow-up of 7 years. Among patients with endometriosis, 86% were identified based on diagnosis codes with a claim of ultrasound, and 14% were defined by diagnostic laparoscopy or surgical treatments. In the Cox proportional hazards model, the adjusted hazard ratio (...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
Dysmenorrhea, the cardinal symptom of endometriosis in adolescents, is too often considered an unavoidable rite of passage that girls must soldier through to become a woman. The concept of primary dysmenorrhea with no anatomic cause embodies the paradigm that dysmenorrhea in adolescents is most often a non-material disorder. These beliefs are likely the root cause of the notoriously delayed diagnosis of endometriosis in adolescents. At the heart of the problem is also the reluctance to conduct diagnostic laparoscopy, the gold standard for diagnosing endometriosis, in adolescents for seemingly common symptoms such as dysmenorrhea.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
Purpose of review The current gold standard for diagnosing endometriosis is laparoscopy with tissue biopsy. This review presents new evidence regarding advanced imaging for more optimal clinical assessment and preoperative evaluation for endometriosis. Recent findings A systematic approach to the imaging evaluation of endometriosis using transvaginal ultrasound and magnetic resonance imaging has been proposed by expert groups and societies. Evidence suggests that new imaging techniques improve the accuracy of clinical diagnosis and facilitate improved preoperative mapping of endometriotic lesions. Summary The clini...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff and Nisse V. Clark Source Type: research
Authors: Leonardi M, Reid S, Lu C, Condous G Abstract OBJECTIVE: It is well-established that there is a strong association between ovarian endometriomas (OE) and deep endometriosis (DE) and rectouterine pouch (RP) obliteration. We aimed to determine the prevalence of DE and RP obliteration in the presence of normal ovaries. METHODS: We conducted a multicentre retrospective cohort study from January 2009 to December 2017 using a prospective multicentre data registry. Participants included patients with signs and/or symptoms of endometriosis who underwent excisional laparoscopic surgery at one of eight hospitals....
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Condition:   Endometriosis, Rectum Interventions:   Diagnostic Test: Transvaginal ultrasound;   Behavioral: 5-point Likert scale Sponsor:   Ospedale Policlinico San Martino Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractPurposeThis is a retrospective cohort study that evaluates the postoperative pain findings of a consecutive series of laparoscopic surgeries for deep endometriosis (DE).MethodsThis multi-center retrospective cohort study was carried out in university hospitals (Istanbul, Turkey). Sixty-five patients diagnosed through bimanual gynecologic examination, gynecologic ultrasound or magnetic resonance imaging-confirmed endometrioma and DE together; who underwent a laparoscopic surgery between 2013 and 2019 by a team of gynecologists, colorectal surgeons, and a urologist were retrospectively evaluated. The data were collec...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
Authors: Chmaj-Wierzchowska K, Rzymski P, Wojciechowska M, Parda I, Wilczak M Abstract Introduction: Endometriosis is a chronic disease that involves the development of endometrium outside the uterine cavity with pain component predominance. The aim of the study was to discuss the occurrence of health problems in patients with endometriomas and simple cysts and the effect of these problems on the daily functioning of the patients. Material and methods: The study included patients (n = 40) treated laparoscopically and/or by laparotomy due to lesions in the form of endometriomas or simple cysts. The control group...
Source: Archives of Medical Science - Category: Biomedical Science Tags: Arch Med Sci Source Type: research
The objective of this study is to investigate the practicality of using ultrasound data to predict low EFI (score ≤6).
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Original Article Source Type: research
The aim of this study was to temporally and externally validate the ultrasound-based endometriosis staging system (UBESS) to predict the level of complexity of laparoscopic surgery for endometriosis.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: ORIGINAL ARTICLE Source Type: research
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