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Late impact of the laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection / Impacto tardio do tratamento laparoscópico da endometriose profunda infiltrativa com ressecção segmentar colorretal
Rocha, Antonio Matos; Albuquerque, Maurício Mendes de; Schmidt, Eduardo Miguel; Freitas, Cristiano Denoni; Farias, João Paulo; Bedin, Fernanda.
  • Rocha, Antonio Matos; University of Southern Santa Catarina. Medical School. Palhoça. BR
  • Albuquerque, Maurício Mendes de; University of Southern Santa Catarina. Medical School. Palhoça. BR
  • Schmidt, Eduardo Miguel; Bahia Sul Hospital. Florianópolis. BR
  • Freitas, Cristiano Denoni; Bahia Sul Hospital. Florianópolis. BR
  • Farias, João Paulo; Bahia Sul Hospital. Florianópolis. BR
  • Bedin, Fernanda; University of Southern Santa Catarina. Medical School. Palhoça. BR
ABCD (São Paulo, Impr.) ; 31(4): e1406, 2018. tab
Article in English | LILACS | ID: biblio-973376
ABSTRACT
ABSTRACT

Background:

Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven.

Aim:

Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection.

Methods:

Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure.

Results:

Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%.

Conclusion:

The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.
RESUMO
RESUMO Racional A endometriose profunda infiltrativa colorretal pode impactar de maneira importante na qualidade de vida e na fertilidade das pacientes. A ressecção segmentar é uma opção terapêutica com resultados positivos na queda dos sintomas, porém ainda sem efeitos funcionais comprovados.

Objetivo:

Avaliar o impacto tardio do tratamento laparoscópico da endometriose profunda infiltrativa com ressecção segmentar colorretal.

Métodos:

Série de casos prospectiva com 46 pacientes submetidas ao tratamento laparoscópico para endometriose profunda infiltrativa com ressecção segmentar colorretal entre 2013 e 2016. Foram analisados sintomas ginecológicos, intestinais e a fertilidade no período pré-operatório, três e 12 meses ou mais após o procedimento.

Resultados:

Na entrevista pré-operatória, foram levantadas as prevalências de sintomas ginecológicos (87%), intestinais (80,4%) e de infertilidade (45,6%). No 3º mês pós-operatório, observou-se redução significativa da prevalência dos sintomas ginecológicos (p<0,001) e de sintomas intestinais, tenesmo (p=0,001) e disquesia (p=0,002). Após 12 meses ou mais observou-se diminuição significativa da prevalência de dismenorreia (p=0,001), de dispareunia profunda (p=0,041) e de dor pélvica crônica (p=0,011) além de disquesia (p=0,001) em relação ao período pré-operatório. As taxas de gravidez total e espontânea foram de 57,1% e 47,6%, respectivamente.

Conclusão:

O tratamento da endometriose profunda infiltrativa com ressecção segmentar colorretal proporcionou alívio precoce e tardio dos sintomas ginecológicos e intestinais. Os resultados sugerem impacto positivo sobre a fertilidade em pacientes inférteis.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Laparoscopy / Colectomy / Endometriosis / Proctectomy Type of study: Evaluation studies / Observational study / Risk factors Limits: Female / Humans / Pregnancy Language: English Journal: ABCD (São Paulo, Impr.) Year: 2018 Type: Article Affiliation country: Brazil Institution/Affiliation country: Bahia Sul Hospital/BR / University of Southern Santa Catarina/BR

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Full text: Available Index: LILACS (Americas) Main subject: Laparoscopy / Colectomy / Endometriosis / Proctectomy Type of study: Evaluation studies / Observational study / Risk factors Limits: Female / Humans / Pregnancy Language: English Journal: ABCD (São Paulo, Impr.) Year: 2018 Type: Article Affiliation country: Brazil Institution/Affiliation country: Bahia Sul Hospital/BR / University of Southern Santa Catarina/BR