Cargando…

Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit

Background. The management of symptomatic rectal endometriosis is a challenging condition that may necessitate limited stripping or limited segmental anterior rectal resection (LSARR) depending upon the extent and severity of the disease. Objective. To report the efficacy of LSARR in terms of pain,...

Descripción completa

Detalles Bibliográficos
Autores principales: English, James, Sajid, Muhammad S., Lo, Jenney, Hudelist, Guy, Baig, Mirza K., Miles, William A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219148/
https://www.ncbi.nlm.nih.gov/pubmed/25146341
http://dx.doi.org/10.1093/gastro/gou055
_version_ 1782342541093371904
author English, James
Sajid, Muhammad S.
Lo, Jenney
Hudelist, Guy
Baig, Mirza K.
Miles, William A.
author_facet English, James
Sajid, Muhammad S.
Lo, Jenney
Hudelist, Guy
Baig, Mirza K.
Miles, William A.
author_sort English, James
collection PubMed
description Background. The management of symptomatic rectal endometriosis is a challenging condition that may necessitate limited stripping or limited segmental anterior rectal resection (LSARR) depending upon the extent and severity of the disease. Objective. To report the efficacy of LSARR in terms of pain, quality of life and short- and long-term complications—in particular, those pertaining to bowel function. Methods. The case notes of all patients undergoing LSARR were reviewed. The analysed variables included surgical complications, overall symptomatic improvement rate, dysmenorrhoea, dyspareunia, and dyschezia. Chronic pain was measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire. Bowel symptoms were assessed using the Memorial Sloan Kettering Cancer Centre (MSKCC) questionnaire. Results. Seventy-four women who underwent LSARR by both open and laparoscopic approaches were included in this study. Sixty-nine (93.2%) women reported improvement in pain and the same percentage would recommend the similar procedure to a friend with the same problem. Approximately 42% of women who wished to conceive had at least one baby. The higher frequency of defecation was a problem in the early post-operative period but this settled in later stages without influencing the quality of life score. Post-operative complications were recorded in 14.9% of cases. Conclusions. LSARR for rectal endometriosis is associated with a high degree of symptomatic relief. Pain relief achieved following LSARR does not appear to degrade with time. As anticipated, some rectal symptoms persist in few patients after long-term follow-up but LSARR is nonetheless still associated with a very high degree of patient satisfaction.
format Online
Article
Text
id pubmed-4219148
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-42191482014-11-05 Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit English, James Sajid, Muhammad S. Lo, Jenney Hudelist, Guy Baig, Mirza K. Miles, William A. Gastroenterol Rep (Oxf) Original Articles Background. The management of symptomatic rectal endometriosis is a challenging condition that may necessitate limited stripping or limited segmental anterior rectal resection (LSARR) depending upon the extent and severity of the disease. Objective. To report the efficacy of LSARR in terms of pain, quality of life and short- and long-term complications—in particular, those pertaining to bowel function. Methods. The case notes of all patients undergoing LSARR were reviewed. The analysed variables included surgical complications, overall symptomatic improvement rate, dysmenorrhoea, dyspareunia, and dyschezia. Chronic pain was measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire. Bowel symptoms were assessed using the Memorial Sloan Kettering Cancer Centre (MSKCC) questionnaire. Results. Seventy-four women who underwent LSARR by both open and laparoscopic approaches were included in this study. Sixty-nine (93.2%) women reported improvement in pain and the same percentage would recommend the similar procedure to a friend with the same problem. Approximately 42% of women who wished to conceive had at least one baby. The higher frequency of defecation was a problem in the early post-operative period but this settled in later stages without influencing the quality of life score. Post-operative complications were recorded in 14.9% of cases. Conclusions. LSARR for rectal endometriosis is associated with a high degree of symptomatic relief. Pain relief achieved following LSARR does not appear to degrade with time. As anticipated, some rectal symptoms persist in few patients after long-term follow-up but LSARR is nonetheless still associated with a very high degree of patient satisfaction. Oxford University Press 2014-11 2014-08-21 /pmc/articles/PMC4219148/ /pubmed/25146341 http://dx.doi.org/10.1093/gastro/gou055 Text en © The Author(s) 2014. Published by Oxford University Press and the Digestive Science Publishing Co. Limited. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
English, James
Sajid, Muhammad S.
Lo, Jenney
Hudelist, Guy
Baig, Mirza K.
Miles, William A.
Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title_full Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title_fullStr Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title_full_unstemmed Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title_short Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
title_sort limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219148/
https://www.ncbi.nlm.nih.gov/pubmed/25146341
http://dx.doi.org/10.1093/gastro/gou055
work_keys_str_mv AT englishjames limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit
AT sajidmuhammads limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit
AT lojenney limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit
AT hudelistguy limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit
AT baigmirzak limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit
AT mileswilliama limitedsegmentalrectalresectioninthetreatmentofdeeplyinfiltratingrectalendometriosis10yearsexperiencefromatertiaryreferralunit