Alexandra Badescu1, Horace Roman2, Moutaz Aziz3, Lucian Puscasiu4, Claudiu Molnar4, Emmanuel Huet5, Jean-Christophe Sabourin6, Simona Stolnicu7. 1. Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Targu Mures, Romania. 2. Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; Research Group 4308 "Spermatogenesis and Gamete Quality", IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France. Electronic address: horace.roman@gmail.com. 3. Research Group 4308 "Spermatogenesis and Gamete Quality", IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France. 4. Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Targu Mures, Romania. 5. Department of Surgery, Rouen University Hospital, Rouen, France. 6. Department of Pathology, Rouen University Hospital, Rouen, France. 7. Department of Pathology, University of Medicine and Pharmacy, Targu Mures, Romania.
Abstract
OBJECTIVE: To provide a mapping of bowel occult microscopic endometriosis implants from colorectal specimens removed from patients who had undergone colorectal resection for deep endometriosis infiltrating the rectum. DESIGN: A series of consecutive patients with deep endometriosis infiltrating the rectum or/and sigmoid colon, between January 2013 and December 2013. SETTING: University tertiary referral center. PATIENT(S): Twenty-six patients with deep endometriosis infiltrating the rectum or/and sigmoid colon. INTERVENTION(S): Surgical management by colorectal resection. MAIN OUTCOME MEASURE(S): Twenty-six patients with prospective recording of data (age, clinical history, symptoms, preoperative assessment, and intraoperative findings) underwent colorectal resection for bowel endometriosis. Mapping of occult microscopic endometriosis implants from specimens was established by histologic examination of 1,051 microsection slides taken from transversal macrosections of 3-mm thickness (40 microsections per patient on average). RESULT(S): The mean (SD) length of colorectal specimens was 110 (42) mm. Microimplants were found at varying distances up to 54 mm from macronodule limits. Multiple macroscopic nodules were identified in five patients (19.2%). In 18 specimens (69%) diffusion of endometriosis microimplants was longitudinal, whereas in 8 specimens (31%) diffusion was concentrated around the macroscopic nodule. Respectively, 31%, 19%, 8%, and 4% of patients presented with endometriosis microimplants at 2, 3, 4, and 5 cm from macroscopic nodules. CONCLUSION(S): The present data suggest that in patients presenting with deep colorectal endometriosis, microscopically complete excision of rectal endometriosis may be unachievable because of bowel occult microscopic endometriosis implants located far from macroscopic nodules.
OBJECTIVE: To provide a mapping of bowel occult microscopic endometriosis implants from colorectal specimens removed from patients who had undergone colorectal resection for deep endometriosis infiltrating the rectum. DESIGN: A series of consecutive patients with deep endometriosis infiltrating the rectum or/and sigmoid colon, between January 2013 and December 2013. SETTING: University tertiary referral center. PATIENT(S): Twenty-six patients with deep endometriosis infiltrating the rectum or/and sigmoid colon. INTERVENTION(S): Surgical management by colorectal resection. MAIN OUTCOME MEASURE(S): Twenty-six patients with prospective recording of data (age, clinical history, symptoms, preoperative assessment, and intraoperative findings) underwent colorectal resection for bowel endometriosis. Mapping of occult microscopic endometriosis implants from specimens was established by histologic examination of 1,051 microsection slides taken from transversal macrosections of 3-mm thickness (40 microsections per patient on average). RESULT(S): The mean (SD) length of colorectal specimens was 110 (42) mm. Microimplants were found at varying distances up to 54 mm from macronodule limits. Multiple macroscopic nodules were identified in five patients (19.2%). In 18 specimens (69%) diffusion of endometriosis microimplants was longitudinal, whereas in 8 specimens (31%) diffusion was concentrated around the macroscopic nodule. Respectively, 31%, 19%, 8%, and 4% of patients presented with endometriosis microimplants at 2, 3, 4, and 5 cm from macroscopic nodules. CONCLUSION(S): The present data suggest that in patients presenting with deep colorectal endometriosis, microscopically complete excision of rectal endometriosis may be unachievable because of bowel occult microscopic endometriosis implants located far from macroscopic nodules.
Authors: H Roman; B Merlot; D Forestier; M Noailles; E Magne; T Carteret; J-T Tuech; D C Martin Journal: Hum Reprod Date: 2021-02-18 Impact factor: 6.918
Authors: Antonio Simone Laganà; Simone Garzon; Martin Götte; Paola Viganò; Massimo Franchi; Fabio Ghezzi; Dan C Martin Journal: Int J Mol Sci Date: 2019-11-10 Impact factor: 5.923