A general surgeon’s opinion about surgical treatment for deeply infiltrating endometriosis


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To formulate the management concept for deeply infiltrating endometriosis. Material and methods. The literature data available in the Pubmed search database and the results of the authors’ own clinical observations during 2010-2016 were analyzed. Results. The paper shows a general surgeon’s role in the surgical treatment of infiltrating endometriosis. It highlights the clinical manifestations of common forms of endometriosis; preoperative examination to detect visceral lesions; surgical access and volume in view of a multidisciplinary approach; and types of possible postoperative complications. Conclusion. Involvement of multidisciplinary groups in the examination and surgical treatment is justified by clinical and economic results and will provide a way to use radical and least invasive techniques in combination with an individual approach.

Full Text

Restricted Access

About the authors

Vladimir Dmitrievich Chuprynin

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of the Department of General Surgery

Elena Grigorevna Khilkevich

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_khilkevich@oparina4.ru
leading researcher of General Surgery

Natalya Aleksandrovna Buralkina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: n_buralkina@oparina4.ru
doctor of Medical Sciences, Senior Researcher, the second gynecological department

Mikhail Viktorovich Melnikov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Candidate of Medical Sciences, Head in Clinical Work, Department of Surgery

Vyacheslav Vladimorovich Chursin

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chursen@oparina4.ru
doctor surgeon of General Surgery

Aleksandr Viktorovich Veredchenko

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_veredchenko@oparina4.ru
candidate of medical sciences, doctor surgeon of General Surgery

Shaxrezat F. Saiddanesh

I.M. Sechenov First Moscow State Medical University

Email: sh_ saiddanesh@oparina4.ru
Postgraduate Student, Department of Obstetrics, Gynecology, Perinatology, and, Reproductology, Faculty for Postgraduate Professional Training of Physicians

References

  1. Jenkins S., Olive D.L., Haney A.F. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet. Gynecol. 1986; 67(3): 335-8.
  2. Chapron C., Fauconnier A., Vieira M., Barakat H., Dousset B., Pansini V. et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum. Reprod. 2003; 18(1): 157-61.
  3. D’Hooghe T.M., Debrock S., Hill J.A., Meuleman C. Endometriosis and subfertility: is the relationship resolved? Semin. Reprod. Med. 2003; 21(2): 243-54.
  4. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil. Steril. 1997; 67(5): 817-21.
  5. Bailey H.R., Ott M.T., Hartendorp P. Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum. 1994; 37(8): 747-53.
  6. Campagnacci R., Perretta S., Guerrieri M., Paganini A.M., De Sanctis A., Ciavattini A., Lezoche E. Laparoscopic colorectal resection for endometriosis. Surg. Endosc. 2005; 19(5): 662-4.
  7. Kaufman L.C., Smyrk T.C., Levy M.J., Enders F.T., Oxentenko A.S. Symptomatic intestinal endometriosis requiring surgical resection: clinical presentation and preoperative diagnosis. Am. J. Gastroenterol. 2011; 106(7): 1325-32.
  8. Floberg J., Bäckdahl M., Silferswärd C., Thomassen P.A. Postpartum perforation of the colon due to endometriosis. Acta Obstet. Gynecol. Scand. 1984; 63(2): 183-4.
  9. Seaman H.E., Ballard K.D., Wright J.T., de Vries C.S. Endometriosis and its coexistence with irritable bowel syndrome and pelvic inflammatory disease: findings from a national case-control study--Part 2. BJOG. 2008; 115(11): 1392-6.
  10. Roseau G., Dumontier I., Palazzo L., Chapron C., Dousset B., Chaussade S. et al. Rectosigmoid endometriosis: endoscopic ultrasound features and clinical implications. Endoscopy. 2000; 32(7): 525-30.
  11. Hudelist G., English J., Thomas A.E., Tinelli A., Singer C.F., Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2011; 37(3): 257-63.
  12. Anaf V., El Nakadi I., De Moor V., Coppens E., Zalcman M., Noel J.C. Anatomic significance of a positive barium enema in deep infiltrating endometriosis of the large bowel. World J. Surg. 2009; 33(4): 822-7.
  13. Bazot M., Darai E., Hourani R., Thomassin I., Cortez A., Uzan S., Buy J.N. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004; 232(2): 379-89.
  14. Grasso R.F., Di Giacomo V., Sedati P., Sizzi O., Florio G., Faiella E. et al. Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom. Imaging. 2010; 35(6): 716-25.
  15. Черняховская Н.Е., Андреев В.Г., Поваляев А.В. Диагностическая лапароскопия. М.: МЕДпресс-информ; 2009. 136с. [Chernyakhovskaya N.E., Andreev V.G., Povalyaev A.V. Diagnostic laparoscopy. Мoscow: MEDpress-inform; 2009. 136p. (in Russian)]
  16. Del Frate C., Girometti R., Pittino M., Del Frate G., Bazzocchi M., Zuiani C. Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics. 2006; 26(6): 1705-18.
  17. Garry R. The effectiveness of laparoscopic excision of endometriosis. Curr. Opin. Obstet. Gynecol. 2004; 16(4): 299-303.
  18. Jacobson T.Z., Duffy J.M., Barlow D., Koninckx P.R., Garry R. Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database Syst. Rev. 2009; (4): CD001300.
  19. Keckstein J., Wiesinger H. Deep endometriosis, including intestinal involvement--the interdisciplinary approach. Minim. Invasive Ther. Allied Technol. 2005; 14(3): 160-6.
  20. Kennedy S., Bergqvist A., Chapron C., D’Hooghe T., Dunselman G., Greb R. et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum. Reprod. 2005; 20(10): 2698-704.
  21. Crosignani P.G., Vercellini P., Biffignandi F., Costantini W., Cortesi I., Imparato E. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil. Steril. 1996; 66(5): 706-11.
  22. Dunselman G.A., Vermeulen N., Becker C., Calhaz-Jorge C., D’Hooghe T., De Bie B. et al. ESHRE guideline: management of women with endometriosis. Hum. Reprod. 2014; 29(3): 400-12.
  23. Meuleman C., Tomassetti C., D’Hoore A., Van Cleynenbreugel B., Penninckx F., Vergote I., D’Hooghe T. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum. Reprod. Update. 2011; 17(3): 311-26.
  24. Redwine D.B., Wright J.T. Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil. Steril. 2001; 76(2): 358-65.
  25. Remorgida V., Ragni N., Ferrero S., Anserini P., Torelli P., Fulcheri E. The involvement of the interstitial Cajal cells and the enteric nervous system in bowel endometriosis. Hum. Reprod. 2005; 20(1): 264-71.
  26. Roman H., Opris I., Resch B., Tuech J.J., Sabourin J.C., Marpeau L. Histopathologic features of endometriotic rectal nodules and the implications for management by rectal nodule excision. Fertil. Steril. 2009; 92(4): 1250-2.
  27. De Cicco C., Corona R., Schonman R., Mailova K., Ussia A., Koninckx P. Bowel resection for deep endometriosis: a systematic review. BJOG. 2011; 118(3): 285-91.
  28. Redwine D.B., Sharpe D.R. Laparoscopic segmental resection of the sigmoid colon for endometriosis. J. Laparoendosc. Surg. 1991; 1(4): 217-20.
  29. Duepree H.J., Senagore A.J., Delaney C.P., Marcello P.W., Brady K.M., Falcone T. Laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement. J. Am. Coll. Surg. 2002; 195(6): 754-8.
  30. Mereu L., Ruffo G., Landi S., Barbieri F., Zaccoletti R., Fiaccavento A. et al. Laparoscopic treatment of deep endometriosis with segmental colorectal resection: short-term morbidity. J. Minim. Invasive Gynecol. 2007; 14(4): 463-9.
  31. Ruffo G., Scopelliti F., Scioscia M., Ceccaroni M., Mainardi P., Minelli L. Laparoscopic colorectal resection for deep infiltrating endometriosis: analysis of 436 cases. Surg. Endosc. 2010; 24(1): 63-7.
  32. Stepniewska A., Pomini P., Bruni F., Mereu L., Ruffo G., Ceccaroni M. et al. Laparoscopic treatment of bowel endometriosis in infertile women. Hum. Reprod. 2009; 24(7): 1619-25.
  33. Van den Broeck U., Meuleman C., Tomassetti C., D’Hoore A., Wolthuis A., Van Cleynenbreugel B. et al. Effect of laparoscopic surgery for moderate and severe endometriosis on depression, relationship satisfaction and sexual functioning: comparison of patients with and without bowel resection. Hum. Reprod. 2013; 28(9): 2389-97.
  34. Daraï E., Dubernard G., Coutant C., Frey C., Rouzier R., Ballester M. Randomized trial of laparoscopically assisted versus open colorectal resection for endometriosis: morbidity, symptoms, quality of life, and fertility. Ann. Surg. 2010; 251(6): 1018-23.
  35. Wolthuis A.M., Meuleman C., Tomassetti C., D’Hooghe T., Fieuws S., Penninckx F., D’Hoore A. Laparoscopic sigmoid resection with transrectal specimen extraction: a novel technique for the treatment of bowel endometriosis. Hum. Reprod. 2011; 26(6): 1348-55.
  36. De Ceglie A., Bilardi C., Blanchi S., Picasso M., Di Muzio M., Trimarchi A., Conio M. Acute small bowel obstruction caused by endometriosis: a case report and review of the literature. World J. Gastroenterol. 2008; 14(21): 3430-4.
  37. Ruffo G., Stepniewska A., Crippa S., Serboli G., Zardini C., SteinkassererM. et al. Laparoscopic ileocecal resection for bowel endometriosis. Surg. Endosc. 2011; 25(4): 1257-62.
  38. Meuleman C., Tomassetti C., D’Hoore A., Buyens A., Van Cleynenbreugel B., Fieuws S. et al. Clinical outcome after CO2 laser laparoscopic radical excision of endometriosis with colorectal wall invasion combined with laparoscopic segmental bowel resection and reanastomosis. Hum. Reprod. 2011; 26(9): 2336-43.
  39. Ghezzi F., Cromi A., Ciravolo G., Rampinelli F., Braga M., Boni L. A new laparoscopic-transvaginal technique for rectosigmoid resection in patients with endometriosis. Fertil. Steril. 2008; 90(5): 1964-8.
  40. Minelli L., Fanfani F., Fagotti A., Ruffo G., Ceccaroni M., Mereu L. et al. Laparoscopic colorectal resection for bowel endometriosis: feasibility, complications, and clinical outcome. Arch. Surg. 2009; 144(3): 234-9; discussion 239.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2017 Bionika Media