Multidisciplinary laparoscopic treatment for bowel endometriosis

Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):53-67. doi: 10.1016/j.bpg.2013.11.008. Epub 2013 Dec 2.

Abstract

Endometriosis is a handicapping disease affecting young females in the reproductive period. It mainly occurs in the pelvis and affects the bowel in 3-37%. Endometriosis can cause menstrual and non-menstrual pelvic pain and infertility. Colorectal involvement results in alterations of bowel habit such as constipation, diarrhoea, tenesmus, and rarely rectal bleeding. A precise diagnosis about the presence, location and extent is necessary. Based on clinical examination, the diagnosis of bowel endometriosis can be made by transvaginal ultrasound, barium enema examination and magnetic resonance imaging. Multidisciplinary laparoscopic treatment has become the standard of care and depending on size of the lesion and site of involvement full-thickness disc excision or bowel resection is performed by an experienced colorectal surgeon. Anastomotic complications occur around 1%. Long-term outcome after bowel resection for severe endometriosis is good with a pregnancy rate of 50%.

Keywords: Colorectal endometriosis; Deeply infiltrative endometriosis; Diagnosis; Endometriosis; Laparoscopy; Treatment.

Publication types

  • Review

MeSH terms

  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / methods*
  • Digestive System Surgical Procedures / standards
  • Endometriosis / complications
  • Endometriosis / diagnosis
  • Endometriosis / surgery*
  • Female
  • Fertility
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / physiopathology
  • Infertility, Female / surgery
  • Interdisciplinary Communication
  • Intestinal Diseases / complications
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / surgery*
  • Laparoscopy* / adverse effects
  • Laparoscopy* / standards
  • Patient Care Team* / standards
  • Pelvic Pain / etiology
  • Pelvic Pain / surgery
  • Pregnancy
  • Pregnancy Rate
  • Recovery of Function
  • Standard of Care
  • Treatment Outcome