Colorectal resection is a standard surgical treatment of bowel deep infiltrating endometriosis (DIE). Nevertheless, concerns about different bowel functional outcomes related to radical surgery versus conservative surgery as shaving technique is a topic leading to much debate. Different surgical approach are used to perform colorectal resection and there is not a standardized technique. For the same concerns, studies have addressed the mesenteric vascular and nerve preservation both in oncological and benign intestinal disease with improved functional outcome. Therefore, the aim of this prospective study is to analyze feasibility and safety of mesenteric vascular and nerve Sparing Surgery in laparoscopic segmental colorectal resection for DIE with short and long term follow up. Women with DIE ,that underwent laparoscopic segmental colorectal resection, will undergo resection performed with inferior mesenteric artery and branching arteries preservation by dissecting adherent to the intestinal wall with mesenteric vascularization and innervation entirely preserved. Personal history, clinical data, surgical data, short and long term surgical complications and long term outcomes will be recorded. Symptoms and bowel function will be evaluated before and after surgery.
Study Type
OBSERVATIONAL
Enrollment
50
Laparoscopic segmental colorectal resection performed by dissecting adherent to the intestinal wall with mesenteric vascularization and innervation entirely preserved.
Change in endometriosis related dysmenorrhea evaluated by Numeric Rating Scale for Pain
Dysmenorrhea in 0 - 10 range according to the Numeric Rating Scale for Pain
Time frame: Change from baseline dysmenorrhea at 60 days after surgery and at 1 year after surgery
Change in endometriosis related dyschezia evaluated by Numeric Rating Scale for Pain
Dyschezia in 0 - 10 range according to the Numeric Rating Scale for Pain
Time frame: Change from baseline dyschezia at 60 days after surgery and at 1 year after surgery
Change in endometriosis related dyspareunia evaluated by Numeric Rating Scale for Pain
Dyspareunia in 0 - 10 range according to the Numeric Rating Scale for Pain.
Time frame: Change from baseline dyspareunia at 60 days after surgery and at 1 year after surgery
Change in endometriosis related dysuria evaluated by Numeric Rating Scale for Pain
Dysuria in 0 - 10 range according to the Numeric Rating Scale for Pain.
Time frame: Change from baseline dysuria at 60 days after surgery and at 1 year after surgery
Change in endometriosis related pelvic chronic pain evaluated by Numeric Rating Scale for Pain
Pelvic chronic pain in 0 - 10 range according to the Numeric Rating Scale for Pain.
Time frame: Change from baseline pelvic chronic pain at 60 days after surgery and at 1 year after surgery
Change in bowel symptoms evaluated by Constipation Assessment Scale
Bowel symptoms in 0 - 16 range according to the Constipation Assessment Scale. Constipation Assessment Scale includes eight items, each of which is self-rated by the patient as 'no problem' (score of 0), 'some problem' (score of 1), or 'severe problem' (score of 2). The item ratings are then summed, so the overall score may range from 0 (no constipation) to 16 (worst possible constipation).
Time frame: Change from baseline bowel symptoms at 60 days after surgery and at 2 year after surgery
Endometriosis characteristics
rAFS classification
Time frame: intraoperative
Complication rate
Number of surgical complications (Clavien-Dindo Classification)
Time frame: Within 6 months after surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.