Treatment of rectosigmoid endometriosis by laparoscopic reverse submucosal dissection (LRSD) : The Sydney partial thickness discoid excision technique
© 2023 Royal Australian and New Zealand College of Obstetricians and Gynaecologists..
BACKGROUND: Laparoscopic reverse submucosal dissection (LRSD) is a standardised surgical technique for removal of rectosigmoid endometriosis which optimises the anatomical dissection plane for excision of endometriotic nodules.
AIM: This cohort study assesses the outcomes of the first cohort of women treated by LRSD, for deeply infiltrating rectosigmoid endometriosis.
MATERIALS AND METHODS: Primary outcomes assessed were complication rate as defined by the Clavien-Dindo system, and completion of the planned LRSD. Secondary outcomes include mucosal breach, specimen margin involvement, length of hospital admission, and a comparison of pre-operative and post-operative pain, bowel function and quality of life surveys. These included the Endometriosis Health Profile Questionnaire (EHP-30), the Knowles-Eccersley-Scott Symptom Questionnaire (KESS) and the Wexner scale.
RESULTS: Of 19 patients treated, one required a segmental resection. The median length of hospital admission was two days (range 1-5) and no post-operative complications occurred. Median pain visual analogue scales (scale 0-10) were higher prior to surgery (dysmenorrhoea 9.0, dyspareunia 7.5, dyschezia 9.0, pelvic pain 6.0) compared to post-surgical median scores (dysmenorrhoea 5.0, dyspareunia 4.0, dyschezia 2.0, pelvic pain 4.0) at a median of six months (range 4-32). Quality of life studies suggested improvement following surgery with pre-operative median EHP-30 and KESS scores (EHP-30: 85 (5-106), KESS score 9 (0-20)) higher than post-operative scores (EHP-30: 48.5 (0-80), KESS score: 3 (0-19)).
CONCLUSION: This series highlights the feasibility of LRSD with low associated morbidity as a progression of partial thickness discoid excision (rectal shaving) for the treatment of rectosigmoid deep infiltrating endometriosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
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| Enthalten in: |
The Australian & New Zealand journal of obstetrics & gynaecology - 64(2024), 2 vom: 29. Apr., Seite 147-153 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Robertson, Jessica [VerfasserIn] |
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| Links: |
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| Themen: |
Deeply infiltrating endometriosis |
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| Anmerkungen: |
Date Completed 18.04.2024 Date Revised 18.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ajo.13762 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363978054 |
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| 100 | 1 | |a Robertson, Jessica |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Treatment of rectosigmoid endometriosis by laparoscopic reverse submucosal dissection (LRSD) |b The Sydney partial thickness discoid excision technique |
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| 500 | |a Date Completed 18.04.2024 | ||
| 500 | |a Date Revised 18.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 Royal Australian and New Zealand College of Obstetricians and Gynaecologists. | ||
| 520 | |a BACKGROUND: Laparoscopic reverse submucosal dissection (LRSD) is a standardised surgical technique for removal of rectosigmoid endometriosis which optimises the anatomical dissection plane for excision of endometriotic nodules | ||
| 520 | |a AIM: This cohort study assesses the outcomes of the first cohort of women treated by LRSD, for deeply infiltrating rectosigmoid endometriosis | ||
| 520 | |a MATERIALS AND METHODS: Primary outcomes assessed were complication rate as defined by the Clavien-Dindo system, and completion of the planned LRSD. Secondary outcomes include mucosal breach, specimen margin involvement, length of hospital admission, and a comparison of pre-operative and post-operative pain, bowel function and quality of life surveys. These included the Endometriosis Health Profile Questionnaire (EHP-30), the Knowles-Eccersley-Scott Symptom Questionnaire (KESS) and the Wexner scale | ||
| 520 | |a RESULTS: Of 19 patients treated, one required a segmental resection. The median length of hospital admission was two days (range 1-5) and no post-operative complications occurred. Median pain visual analogue scales (scale 0-10) were higher prior to surgery (dysmenorrhoea 9.0, dyspareunia 7.5, dyschezia 9.0, pelvic pain 6.0) compared to post-surgical median scores (dysmenorrhoea 5.0, dyspareunia 4.0, dyschezia 2.0, pelvic pain 4.0) at a median of six months (range 4-32). Quality of life studies suggested improvement following surgery with pre-operative median EHP-30 and KESS scores (EHP-30: 85 (5-106), KESS score 9 (0-20)) higher than post-operative scores (EHP-30: 48.5 (0-80), KESS score: 3 (0-19)) | ||
| 520 | |a CONCLUSION: This series highlights the feasibility of LRSD with low associated morbidity as a progression of partial thickness discoid excision (rectal shaving) for the treatment of rectosigmoid deep infiltrating endometriosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a deeply infiltrating endometriosis | |
| 650 | 4 | |a rectal endometriosis | |
| 650 | 4 | |a rectal endometriotic nodule | |
| 650 | 4 | |a rectal shaving, partial thickness discoid excision | |
| 700 | 1 | |a Abbott, Jason |e verfasserin |4 aut | |
| 700 | 1 | |a Corbett-Burns, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Bukhari, Mujahid |e verfasserin |4 aut | |
| 700 | 1 | |a Perera, Shevy |e verfasserin |4 aut | |
| 700 | 1 | |a Kalantan, Assem |e verfasserin |4 aut | |
| 700 | 1 | |a Sarofim, Mikhail |e verfasserin |4 aut | |
| 700 | 1 | |a Chou, Rebecca |e verfasserin |4 aut | |
| 700 | 1 | |a Cario, Greg |e verfasserin |4 aut | |
| 700 | 1 | |a Rosen, David |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Wynn-Williams, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Condous, George |e verfasserin |4 aut | |
| 700 | 1 | |a Chou, Danny |e verfasserin |4 aut | |
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