Standardized laparoscopic colorectal resection for endometriosis: P015


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Abstract

Aim:Emphasize the role of a standardized laparoscopic colorectal resection (LCR) for severe pelvic endometriosis (SPE).Methods:Apreoperative assessment [clinical evaluation, Cleveland Clinic Constipation Score (CCCS), transvaginal US, barium colonic enema and pelvic MRI] was used. The operative steps for LCR were: (1) adhesiolysis; (2) identification of the ureters; (3) left colonic mobilization; (4) rectal mobilization and recto-vaginal septum dissection; (5) detachment of the specimen closely near the organ's wall with thepreservation of theprincipal vascular trunks; (6) nerve sparing (hypogastric plexus); (7) resection and exteriorization of the specimen through a Pfannenstiel incision; (8) a Knight-Griffen anastomosis. Operative time, conversion rate, length of hospitalization, complications, changes in urinary, sexual and bowel functions were analyzed.Results:From January 2008 to December 2009, 75 surgicalprocedures for SPE. Among these, 8 pts (mean age, 29 years) affecting by severe colorectal stenosis had a LCR. Mean operative time was 181 ± 29 min. No ileostomy and conversion to open. No deaths, anastomotic leakage and rectovaginal fistula. Mean hospital stay was 4.3 ± 1.4 days. CCCS improved, (P < 0.05). No urinary and sexual disfunction. Onepregnancy occurred after 3 months.Conclusions:A standardized LCR for endometriosis is safe and effective.

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