Cyril Touboul1, Marcos Ballester, Gil Dubernard, Sonia Zilberman, Anne Thomin, Emile Daraï. 1. Department of Obstetrics and Gynecology, GRC-UPMC 6 (Centre Expert En Endometriose (C3E)), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France, cyril.touboul@gmail.com.
Abstract
BACKGROUND: To evaluate the long-term symptoms, quality of life (QOL), and fertilityafter colorectal resection for endometriosis. METHODS: Extended analysis of a randomized controlled trial including 52 patients with colorectal endometriosis, comparing laparoscopically assisted to open colorectal resection. All included patients were invited to complete questionnaires evaluating the presence and intensity of symptoms and QOL using the SF-36 and fertility at a mean (SD) follow-up of 50.7 (13.8) months. We compared symptoms intensity and QOL before and after surgery at short- (mean follow-up of 19 months) and long-term (mean follow-up of 51 months). RESULTS: Persistent improvement in QOL was noted after surgery without differences between short and long term. Self-catheterization >6 months was the sole factor decreasing the long-term QOL (P = 0.02). No difference in symptoms and QOL was noted according to the route. Among the 28 patients (53.8%) wishing to conceive, 12 (42.9%) conceived within a mean (SD) time of 17 (13) months. No difference in fertility including pregnancy after IVF was noted between the routes, but spontaneous pregnancy occurred only after laparoscopy (P = 0.016). CONCLUSIONS:Symptoms and QOL improvements after colorectal resection last for over 4 years without difference between the routes. Thank to a lower intra- and postoperative complications and higher spontaneous pregnancy rate, laparoscopic colorectal resection should be the first surgical approach.
RCT Entities:
BACKGROUND: To evaluate the long-term symptoms, quality of life (QOL), and fertility after colorectal resection for endometriosis. METHODS: Extended analysis of a randomized controlled trial including 52 patients with colorectal endometriosis, comparing laparoscopically assisted to open colorectal resection. All included patients were invited to complete questionnaires evaluating the presence and intensity of symptoms and QOL using the SF-36 and fertility at a mean (SD) follow-up of 50.7 (13.8) months. We compared symptoms intensity and QOL before and after surgery at short- (mean follow-up of 19 months) and long-term (mean follow-up of 51 months). RESULTS: Persistent improvement in QOL was noted after surgery without differences between short and long term. Self-catheterization >6 months was the sole factor decreasing the long-term QOL (P = 0.02). No difference in symptoms and QOL was noted according to the route. Among the 28 patients (53.8%) wishing to conceive, 12 (42.9%) conceived within a mean (SD) time of 17 (13) months. No difference in fertility including pregnancy after IVF was noted between the routes, but spontaneous pregnancy occurred only after laparoscopy (P = 0.016). CONCLUSIONS: Symptoms and QOL improvements after colorectal resection last for over 4 years without difference between the routes. Thank to a lower intra- and postoperative complications and higher spontaneous pregnancy rate, laparoscopic colorectal resection should be the first surgical approach.
Authors: Ricardo Mendes Alves Pereira; Alysson Zanatta; Christian Day Lima Preti; Fernando José Felipe de Paula; Eduardo Leme Alves da Motta; Paulo César Serafini Journal: J Minim Invasive Gynecol Date: 2009 Jul-Aug Impact factor: 4.137
Authors: Ralf Rothmund; Marcus Scharpf; Christos Tsaousidis; Constanze Planck; Markus Dominik Enderle; Alexander Neugebauer; Kristin Kroeker; Daniela Nuessle; Falko Fend; Sara Brucker; Bernhard Kraemer Journal: Int J Med Sci Date: 2016-02-18 Impact factor: 3.738