부산대학교 도서관

Objective. The aim of this paper is to present the authors' experience and to evaluate the effectiveness of laparoscopic colorectal resection in cases with deep infiltrating endometriosis, as well as the impact on the quality of life, symptomatology and digestive symptoms. Materials and method. During June 2017 until January 2019, a number of 120 patients underwent laparoscopy for deep infiltrative endometriosis. Fourty-two patients with deep endometriosis were included in the study - all the patients included in the study completed a questionnaire on the symptoms of preoperative endometriosis and quality of life (Questionnaire SF-36), and completed the preoperative evaluation (MRI, transvaginal ultrasound, endo-rectal ultrasound, HidroColo-CT). The status and quality of life were assessed postoperatively. The gynecological and digestive symptoms, as well as the rate of perioperative complications were also evaluated. The laparoscopic surgery was performed by the same surgical team in all cases. Results. Twenty patients (47.62%) benefited from laparoscopic segmental rectosigmoid resection with end-to-end mechanical anastomosis. Twenty-one patients (50%) with deep endometriosis benefited from laparoscopic excision of deep endometriosis nodules. The average age of patients was 34 years old. The laparotomy conversion rate was null. Following surgery, a significant improvement in dysmenorrhea, dyspareunia, chronic pelvic pain, defecation pain, and lower abdominal pain was noted. In cases of deep endometriosis and colorectal resection, an improvement in the quality of life score assessed by the SF- 36 questionnaire was observed. One patient (2.38%) refused the colorectal resection for objective reasons. The rate of postoperative complications was 2,38 % (a reintervention at 5 days postoperative for a ileostomial protection in a patient that underwent two intestine resections). The rate of hemoperitoneum, rectovaginal fistula, uroperitoneum and pelvic abscess was null. Conclusions. Laparoscopic segmental colorectal resection for endometriosis significantly improves the quality of life and the gynecological and digestive symptoms. However, women should be informed about the risk of complications, including rectovaginal fistula. The need for adherence to a national guide on the therapeutic conduct in deep endometriosis cases and the standardization of treatment allow us to achieve satisfactory results in terms of improving the quality of life in patients with colorectal resection. The preoperative investigations allow for surgical planning and the formation of a multidisciplinary team for the correct management and the complete excision of endometriotic lesions. [ABSTRACT FROM AUTHOR]