Laparoscopic treatment of 98 women with bowel endometriosis

Abstract

Objective: The purpose of this study was to identify the types of surgical procedures performed and the operative morbidity in women with bowel endometriosis. Methods: Retrospective evaluation of surgical records of women who underwent surgical treatment of endometriosis by a mutidisciplinar team at Biocor Instituto (Belo Horizonte, MG) from January 2002 to June 2009. Results: Ninety-eight women underwent surgical treatment of bowel endometriosis during the study period. The following surgical procedures were performed: segmetnal rectal resection (n 46; 45,5%), intestinal disc excision (n 25; 24,7%), "shaving" (n 18; 17,8%), appendectomy (n 5; 5%), adhesiolysis without intestinal resection (n 5; 5%), segmental sigmoidectomy (n 1; 1%) e segmental right colon resection (n 1, 1%). The most frequent concomitant surgery performed was the removal of ovarian endometriomas (n 45). Operative morbity was observed in 9.2% and major complications were rectovaginal fistula (1%) and anastomosis dehiscence (1%). After a mean followup of 14 months that included 42 patients, recurrence of clinical symptoms (pelvic pain and dyspareunia) was observed in 8 cases as well as 4 cases of asymptomatic intestinal wall endometriosis recurrence which was identified by ultrasonography. Conclusion: Laparoscopic treatment of bowel endometriosis is feasible, safe and presents a low recurrence rate.