Histopathological features of endometriotic rectal nodules and implications on management by rectal nodule excision: P073

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Aim:Investigation focused on whether inside the endometriotic rectal nodules (ERN), glandular lesions remain surrounded by fibro-conjunctive tissue and smooth fibres. The distance between the deepest point of active glandular and deepest fibrotic lesion was measured.Method:Twenty-seven women were included. In 14, both active endometriotic tissue and fibrosis had infiltrated the same rectal layer: muscularispropria (12 cases) and submucosa (two cases).Results:The depth of rectal infiltration by glandular epithelium was superior to that of the fibrosis in 24 cases out of 27 (89%), while fibrosis was responsible for the deepest infiltration in only three women (11%). In 24 women with deep infiltration, the distance from deepest gland to deepest point of fibrosis ranged from 388 lm to 9777 lm (mean 5313). In three cases where fibrotic infiltration was deeper than that of glandular and stromal invasion, the distance between the deepest point of fibrosis and that of endometriotic glands and stroma was 626, 705 and 2323 lm respectively.Conclusion:For the majority of ERN, fibrosis does not surround but follows behind glandular epithelium and stroma foci. The distance between the deepest glandular and deepest fibrosis foci can be 5 mm, surgical excision of all fibrosis may result in leaving active lesions outside the limit of excision.

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