Cherif Akladios1, Pietro Messori2, Emilie Faller2, Marco Puga2, Karolina Afors2, Joel Leroy2, Arnaud Wattiez2. 1. Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France. Electronic address: cherif.youssef2@wanadoo.fr. 2. Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France; IRCAD, Strasbourg, France.
Abstract
OBJECTIVE: To verify the hypothesis that in most patients bowel segmental resection to treat endometriosis can be safely performed without creation of a stoma and to discuss the limitations of this statement. DESIGN: Retrospective study (Canadian Task Force classification III). SETTING: Tertiary referral center. PATIENTS: Forty-one women with sigmoid and rectal endometriotic lesions who underwent segmental resection. INTERVENTION: Segmental resection procedures performed between 2004 and 2011. Patient demographic, operative, and postoperative data were compared. MEASUREMENTS AND MAIN RESULTS: Sigmoid resection was performed in 6 patients (15%), and rectal anterior resection in 35 patients (high in 21 patients [51%], and low, i.e., <10 cm from the anal verge, in 14 [34%]). In 4 patients a temporary ileostomy was created. There was 1 anastomotic leak (2.4%), in a patient with an unprotected anastomosis, which was treated via laparoscopic surgery and creation of a temporary ileostomy. Other postoperative complications included hemoperitoneum, pelvic abscess, pelvic collection, and a ureteral vaginal fistula, in 1 patient each (all 2.4%). CONCLUSION: A protective stoma may be averted in low anastomosis if it is >5 cm from the anal verge and there are no adverse intraoperative events.
OBJECTIVE: To verify the hypothesis that in most patients bowel segmental resection to treat endometriosis can be safely performed without creation of a stoma and to discuss the limitations of this statement. DESIGN: Retrospective study (Canadian Task Force classification III). SETTING: Tertiary referral center. PATIENTS: Forty-one women with sigmoid and rectal endometriotic lesions who underwent segmental resection. INTERVENTION: Segmental resection procedures performed between 2004 and 2011. Patient demographic, operative, and postoperative data were compared. MEASUREMENTS AND MAIN RESULTS: Sigmoid resection was performed in 6 patients (15%), and rectal anterior resection in 35 patients (high in 21 patients [51%], and low, i.e., <10 cm from the anal verge, in 14 [34%]). In 4 patients a temporary ileostomy was created. There was 1 anastomotic leak (2.4%), in a patient with an unprotected anastomosis, which was treated via laparoscopic surgery and creation of a temporary ileostomy. Other postoperative complications included hemoperitoneum, pelvic abscess, pelvic collection, and a ureteral vaginal fistula, in 1 patient each (all 2.4%). CONCLUSION: A protective stoma may be averted in low anastomosis if it is >5 cm from the anal verge and there are no adverse intraoperative events.
Authors: Andrea Balla; Silvia Quaresima; José D Subiela; Mostafa Shalaby; Giuseppe Petrella; Pierpaolo Sileri Journal: Int J Colorectal Dis Date: 2018-05-10 Impact factor: 2.571
Authors: Antonio Simone Laganà; Salvatore Giovanni Vitale; Maria Antonietta Trovato; Vittorio Italo Palmara; Agnese Maria Chiara Rapisarda; Roberta Granese; Emanuele Sturlese; Rosanna De Dominici; Stefano Alecci; Francesco Padula; Benito Chiofalo; Roberta Grasso; Pietro Cignini; Paolo D'Amico; Onofrio Triolo Journal: Biomed Res Int Date: 2016-08-04 Impact factor: 3.411