Clinical, diagnostic, and surgical characteristics of colorectal endometriosis


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Abstract

Aim. To investigate clinical, diagnostic, and surgical features of colorectal endometriosis. Materials and methods. We analyzed medical records of 311 patients who underwent surgery for colorectal endometriosis from January 2018 to December 2020 at the Department of General Surgery of the V.I. Kulakov NMRC for OG&P. Clinical evaluation included general clinical examination, TVUS, MRI, and colonoscopy. The method and scale of surgery were determined by the disease's location, the depth and extent of invasion, and the involvement of surrounding structures. Results. Patients whose findings from TVUS or MRI were insufficient for diagnosis underwent colonoscopy with targeted biopsy of endometriotic lesions [54/311(17.3%)]. TVUS or MRI findings showed endometriotic lesions infiltrating the bowel wall in 136/311 (43.7%) patients. Most often, complaints correlated with the disease location. Rectal bleeding during menstruation was reported by 55/311 (17.6%) patients; 114/311 (36.6%) women complained of bloating during menstruation. These complaints were not present in patients with the endometriotic infiltrate located in the proximal colon or the small intestine. Loose stools were reported by 76/311 (24.4%) patients. Surgical interventions included shaving of bowel wall affected by endometriotic infiltrate [118/311 (37.9%)], resection of affected bowel and anastomosis [161/311 (51.7%)], resection of affected bowel, and colostomy [29/311 (9.3%)], and appendectomy [3/311 (0.9%)]. Conclusion. Colorectal endometriosis is a gynecological disorder showing infiltrative growth, rapid cell proliferation, neoangiogenesis and can mimic malignancy. Endometriotic lesions can be seen only by laparoscopy, but other methods of preoperative examination should not be neglected. This may help better diagnose the disease and guide pre-surgical planning.

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About the authors

E. I Pilyugina

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: elyai3.ii.97@idoud.com
6th Year Student 117997, Russia, Moscow, Ostrovityanova str., i

E. G Khilkevich

V.I. Kulakov NMRC for Ministry of Health of Russia

Email: ekhilkevich@oparina4.ru
Dr. Med. Sci., Obstetrician-Gynecologist at the Surgery Department Russia, Moscow, Ac. Oparina str., 4

M. V Mel'nikov

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: mmelnikov@oparina4.ru
Ph.D., Head in Clinical Work, Surgery Department 117997, Russia, Moscow, Ostrovityanova str., i

V. D Chuprynin

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: vchuprynin@oparina4.ru.ii7997
Ph.D., Head of the Surgery Department 117997, Russia, Moscow, Ostrovityanova str., i

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