Deep pelvic endometriosis (Adamyan IV stage): Multidisciplinary laparoscopic treatments

Abstract

Background: Few small studies have confirmed the feasibility of laparoscopic colorectal resection for Deep Infiltrating Endometriosis (DIE), albeit with a wide range of complications. Aim: The aim of this study is to evaluate retrospectively the feasibility and clinical outcome of laparoscopic segmental bowel resection for DIE. Methods: We have retrospectively reviewed the data of patients undergoing laparoscopic rectosigmoidal resection for bowel endometriosis from January 2000 and June 2008. Data analysis included age, preoperative symptoms, operative procedure, operating room time, intraoperative and postoperative complication, length of stay and Quality of life. Results: 56 colorectal laparoscopic resection for DIE were performed. No conversion occurred. There were no intraoperative complication; 35 patients had a temporary ileostomy and 15 required reoperation for major complication. Conclusion: DIE should be managed in specialised centers with a multidisciplinary equipe; it represents a difficult surgery which require a high surgeon skill and it must be practiced considering both the risks and the benefits.