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Long‐term follow‐up and recurrence rate after mesorectum‐sparing bowel resection among women with rectovaginal endometriosis
Author(s) -
Mangler Mandy,
Herbstleb Julia,
Mechsner Sylvia,
Bartley Julia,
Schneider Achim,
Köhler Christhardt
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.12.010
Subject(s) - medicine , mesorectum , endometriosis , resection , bowel resection , short bowel syndrome , surgery , colorectal cancer , total mesorectal excision , parenteral nutrition , cancer
Objective To demonstrate the quality of a combined vaginal–abdominal surgical approach to rectovaginal endometriosis by analyzing long‐term outcome and recurrence rates. Methods In a prospective cohort study in Berlin, Germany, women with endometriosis of the rectovaginal septum were enrolled between September 2004 and December 2012. Bowel infiltration was verified intraoperatively and treated by a nerve‐sparing, mesentery‐preserving vaginal–abdominal operative approach. Operative results were evaluated by assessing short‐ and long‐term complications and recurrence rates. Results During the study period, 110 women underwent surgery. For 71 (64.5%) patients, bowel infiltration was confirmed intraoperatively. Overall, 15% of the patients had peri‐ or postoperative complications. No long‐term complications occurred. After a median follow‐up of 64 months, no recurrence in the rectovaginal septum was observed among the study patients. The recurrence of pelvic endometriosis was 15%. Conclusion The surgical nerve‐sparing approach to rectovaginal endometriosis was confirmed to facilitate precise diagnosis and treatment with minimal morbidity and a long‐term complication rate of 0%.