Quality of life before and after laparoscopic resection of bowel for deep infiltrating endometriosis
DOI:
https://doi.org/10.6016/ZdravVestn.1337Keywords:
bowel endometriosis, bowel resection, quality of lifeAbstract
Background: Te purpose of the study was to determine the quality of life in patients with bowel endometriosis before and afer laparoscopic bowel resection.
Material and methods: In the retrospective study we included 91 patients who underwent laparoscopic resection of the bowel affected by endometriosis at the Unit for Reproduction and the Unit for Gynecology, Department of Obstetrics and Gynecology Ljubljana, in the period from 2002 to 2011. Te study was retrospective. Te patients were sent a questionnaire regarding the symptoms before surgery and the effect of surgery on bowel symptoms, painful menstruation, painful sexual intercourse, chronic pelvic pain and quality of life before and afer surgery; 76 (83.5 %) patients replied to the questionnaire.
Results: Before surgery, 72 (94.7 %) patients reported painful menstruation. Improvement or complete relief afer surgery was registered in 57 (79.1 %). Out of 60 (78.9 %) patients who had painful sexual intercourse before surgery, 49 (81.7 %) reported improvement or complete relief afer surgery. Bowel symptoms, present in 52 (68.4 %) patients before surgery, improved or completely disappeared in 48 (92.4 %) afer surgery. Chronic pelvic pain, present in 53 (69.7 %) before surgery, decreased or did not exist any more in 45 patients (86.5 %). Te quality of life before surgery was very poor in 32 patients (42.1 %), and poor in 21 patients (27.8 %). Afer the operation, the quality of life was reported as improved in 22 (28.9 %) and signifcantly improved in 42 (55.3 %).
Conclusions: Laparoscopic bowel resection, indicated in extensive symptomatic endometriosis, signifcantly improves the patients’ quality of life.
Downloads
References
Shaw R, Luesley D. Monga A. Genaecology. 4th ed. Edinbourgh: Churchill Livingstone; 2011. p. 488–89.
Bianconi L, Hummelshoj L, Coccia ME, Vigano P, Vittori G, Veit J, et al. Recognizing endometriosis as a social disease: the European union-encouraged Italian Senate approach. Fertil Steril. 2007; 88(5): 1285–7.
Ribič-Pucelj M. Globoka infltrativna endometrioza. Zdrav Vestn. 2009; 78 Suppl I: 5–9. 4. Keckstein J, Wiesinger H. Te laparoscopic treatment of intestinal endometriosis. In: Sutton C, Adamson G, ur. Modern management of endometriosis. London, New York: Taylor & Francis; 2006. p. 177–87.
Jelenc F, Ribič-Pucelj M, Juvan R, Kobal B. Laparoscopically asssisted resection of rectosigmoid colon affected by endometriosis. In: Book of proceedings of the 15th basic and advanced course on gynecological endoscopic surgery with internati onal participation; 2010 Jun 7–11; Ljubljana, Slovenia. Ljubljana: Slovene society of reproductive medicine; 2010.
Ribič-Pucelj M, Jelenc F. Endometrioza črevesa. Endoscopic Rev. 2012; 17(34): 9–16.
Doniec JM, Kahlke V, Peetz F, Schniewind B, Mundhenke C, Löhnert MS, et al. Rectal endometriosis: high sensitivity and specifcity of endorectal ultrasound with an impact for the operative management. Dis Colon Rectum. 2003; 46(12): 1667–73.
Hudelist G, Tuttlies F, Rauter G, Pucher S, Keckstein J. Can transvaginal sonography predict infltration depth in patients with deep infltrating endometriosis of the rectum? Hum Reprod Oxf Eng. 2009; 24(5): 1012–7.
Olive DL, Pritts EA. Treatment of endometriosis. N Engl J Med. 2001; 26; 345(4): 266–75.
Jelenc F, Ribič-Pucelj M, Šinkovec J. Bowel endometriosis: In: Ribič-Pucelj M, ed. Endoscopic surgery in gynecology. Radovljica: Didakta; 2007. p. 194–203.
Jelenc F, Ribič-Pucelj M, Juvan R, Kobal B, Šinkovec J, Šalamun V. Laparoscopic rectal resection of deep infltrating endometriosis. J Laparoendosc Adv Surg Tech A. 2012; 22(1): 66–9.
Meuleman C, Tomassetti C, D’Hoore A, Van Cleynebreugel B, Penninckx F, Vergote I, et al. Clinical outcome afer CO2 laser laparoscopic radical excision of endometriosis with colorectal wall invasion combined with segmental bowel resection and anastomosis. Hum Reprod. 2011; 26(9): 2336–43.
Setälä M, Härkki P, Matomäki J, Mäkinen J, Kössi J. Sexual functionong, quality of life and pelvic pain 12 months afer endometriosis surgery including vaginal resection. Acta Obstet Gynecol Scand. 2012(6): 692–8.
Bailly E, Marquiles AL, Letochic A, Fraleu-Louer B, Renouvel F, Panel P. Evolution of symptoms and quality of life of patients afer surgery of digestive endometriosis. Gynecol Obstet Fertil. 2013; 41(11): 627–34.
Kockerling F, Rose J, Shneider C, Scheidbach M, Scheurlein H, Reymond MA, et al. Laparoscopic colorectal anastomosis: risk of postoperative leakage-results of a multicenter study (Laparoscopic Colorectal Surgery Group (LCSSG). Surg Endosc. 1999; 13: 639–44.
Donnez J, Squifet J. Complications, pregnancy and recurrence in a prospective series of 500 patients operated on by the shaving technique for deep rectovaginal endometriotic nodules. Hum Reprod. 2010; 5(8): 1949–58.
De Cicco C, Corona R, Schonman R, Mailova K, Ussia A, Koninckx PR. Bowel resection for deep endometriosis: a systematic review. BJOG. 2011; 118(3): 285–91.
Darai E, Dupernard G, Coutant C, Frey C, Rouzier R, Ballester M. Randomized trial of laparoscopically assisted versus open colorectal resection for endometriosis. Ann Surg. 2010; 251(6): 1018–23.
Touboul C, Ballester M, Dubernard G, Zilberman S, Tomin A, Darai E. Longterm symptoms, quality of life, and fertility afer colorectal resection for endometriosis: extended analysis of randomized controlled trial comparing laparoscopically assisted to open surgery. Surg Endosc 2015; 29(7): 1879–87.
Brouwer R, Woods RJ. Rectal endometriosis: Results of radical excision and review of published work. ANZ J Surg. 2007; 77(7): 562–71.
Minelli L, Fanfani F, Fagotti A, Ruffo G, Ceccaroni M, Mereu L et al. Laparoscopic colorectal resection for bowel endometriosis. Arch Surg. 2009; 144(3): 234–9.
Kossi J, Setala M, Enholm B, Luostarinen M. Te early outcome of laparoscopic sigmoid and rectal resection for endometriosis. Colorectal Dis. 2010; 12(3): 232–5.
Canon B, Collinet P. Piessen G. Rubod C. Segmentary rectal resection and rectal shaving by laparoscopy for endometriosis: perioperative morbidity. Gynecol Obstet Fertil. 2013; 41(5): 275–81.
Roman H, Vassilieff M, Gourcerol G, Savoye G, Leroi AM, Marpeau L, et al. Surgical management of deep infltrating endometriosis of the rectum: pleading for a symptom guided approach. Hum Reprod. 2011; 26(2): 274–81.
Acien P, Nunez C, Quereda F, Velasco I, Valiente M, Vidal V. Is a bowel resection necessary for deep endometriosis with rectovaginal or colorectal involvement? Int J Womenes Health. 2013; 5: 449–55.
Baley AP, Schutt AK, Modesitt SC. Florid endomestriosis in postmenopausal women. Fertil Steril. 2010; 94(7): 2769.
Namnoum AB., Hickman TN, Goodman SB, Gehlbach DL, and Rock JA. Incidence of symptom recurrence afer hysterectomy for endometriosis. Fertil Steril. 1995; 64(5): 898–902.
Garry R, Fountain J, Mason S, Napp V, Abbot J, Clayton R, et al. Te evaluate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004; 328(7432): 129.
Dubernard G, Piketty M, Rouzier R, Houry S, Bazot M, Darai E, et al. Quality of life afer laparoscopic colorectal resection in endometriosis. Hum Reprod. 2006; 21(5): 1243–7.
Dousset B, Leconte M, Borghese B, Millischer AE, Roseau G, Arkwright S, et al. Complete surgery for low rectal endometriosis: longterm results of a 100-case prospective study. Ann Surg. 2010; 251(5): 887–95.
Remorgida V, Ragni N, Ferrero S, Anserini P, Torelli P, Fulcheri E. How complete is full thickness disc resection of bowel endometriotic lesions? A prospective surgical and histological study. Hum Reprod. 2005; 20(8): 2317–20.
Stern RC, Dash R, Bentley RC, Snyder MJ, Haney AF, Robboy SJ. Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types. Int J Gynecol Pathol. 2001; 20(2): 133–39.
Yantis RK, Clement PB, Young RH. Neoplastic and preneoplastic changes in gastrointestinal endometriosis: a study of 17 cases. Am J Surg Pathol. 2000; 24(4): 513–24.
Darai E, Ackerman G, Bazot M, Rouzier R, Dubernard G. Laparoscopic segmental colorectal resection for endometriosis: limits and complications. Surg Endosc. 2007; 21(9): 1572–7.
Mangler M, Herbstleb J, Mechsner S, Bartley J, Schneider A, Köhler C. Long-term follow-up and recurrence rate afer mesorectum-sparing bowel resection among women with rectovaginal endometriosis. Int J Gynaecol Obstet. 2014; 25(3): 266–9.
Kossi J, Satala M, Makinen J, Härkki P, Loustarinen M. Quality of life and sexual function 1 year afer laparoscopic rectosigmoid resection for endometriosis. Colorectal Dis. 2013; 15(1): 102–8.
Silveira de Cunha Araujo R, Abdalla Ayrosa Ribeiro HS, Sekula VG, De Costa Porto BT, Ayroza Galvao Ribeiro PA. Long-term outcomes of life in women submitted to laparoscopic treatment for bowel endometriosis. J Minim Invasive Gynecol. 2014; 21(4): 682–8.
Bassi MA, Podgaec S, Dias JA Jr, D Amico Filho N, Petta CA, Abrao MS. Quality of life afer segmental resection of the rectosigmoid by laparoscopy in patients with deep infltrating endometriosis with bowel endometriosis. J Minim Invasive Gynecol. 2011; 18(6): 730–3.
Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D‘Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014; 29(3): 400–12.
Downloads
Published
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
