Histopathology-based combined surgical approach to rectovaginal endometriosis

被引:16
作者
Mangler, Mandy [1 ]
Loddenkemper, Christoph [2 ]
Lanowska, Malgorzata [1 ]
Bartley, Julia [1 ]
Schneider, Achim [1 ]
Koehler, Christhardt [1 ]
机构
[1] Charite Campus Mitte, Dept Gynecol, D-10117 Berlin, Germany
[2] Charite Campus Benjamin Franklin, Inst Pathol, Berlin, Germany
关键词
Bowel endometriosis; Histopathologic evaluation; Mesopreservation; Operative strategies; Rectovaginal endometriosis;
D O I
10.1016/j.ijgo.2008.06.009
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To describe a new surgical approach to rectovaginal endometriosis. Rectovaginal endometriosis can be infiltrative or superficial involving the bowel. Only infiltrative disease should be treated by intestinal resection. However, infiltration of endometriosis cannot be confirmed by preoperative imaging techniques. Methods: A total of 48 women with infiltrative rectovaginal endometriosis were included in this prospective study. Surgery was performed using a newly developed technique. All bowel resections were indicated according to operative findings and not on the basis of preoperative imaging technique results. Results: The decision for rectosigmoidal resection was based on the results of the intraoperative dissection of the rectovaginal septum. Histologically, infiltration of the ventral bowel wall was confirmed in all cases. Conclusion: This new surgical technique for the treatment of rectovaginal endometriosis allows precise diagnosis and treatment with low morbidity. A resection of the mesorectum is not necessary because the endometriotic nodules are always located on the antimesenteric surface of the bowel. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:59 / 64
页数:6
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