Langebrekke Anton, Istre Olav, Busund Bjørn, Johannessen Hans-Olaf, Qvigstad Erik
Department of Gynaecology, Ullevål University Hospital, Oslo, Norway.
Acta Obstet Gynecol Scand. 2006;85(6):712-5. doi: 10.1080/00016340500449907.
To study the feasibility, complications and symptom relief of laparoscopic treatment in patients with deep infiltrating endometriosis.
From January 2004 to March 2005, 24 patients with deep infiltrating endometriosis were treated with laparoscopic techniques. Preoperative symptoms, staging, involvement of the disease, and surgical procedures were recorded. Operating time and perioperative complications were also registered, as well as follow-up of the patients.
The surgical treatment was individualized with removal of deep infiltrating endometriosis in all 24 patients, additional bladder resection in five patients and colorectal resection in eight patients. In two cases laparoconversion was performed, and one patient had a temporary loop ileostomy. We observed no major peri- or postoperative complications. Median operating time was 3.4 h (range 1.4-8.0 h). All patients with bladder involvement were relieved of their urinary dysfunction, while all except three patients were successfully treated for their pain problems, and also these three patients had symptom relief.
Patients with deep infiltrating endometriosis represent a challenge to surgical procedures. Our results show that radical laparoscopic surgery including colorectal and bladder resection is feasible, safe, and effective in almost all patients.
研究腹腔镜治疗深部浸润型子宫内膜异位症患者的可行性、并发症及症状缓解情况。
2004年1月至2005年3月，采用腹腔镜技术治疗24例深部浸润型子宫内膜异位症患者。记录术前症状、分期、疾病累及情况及手术方式。还记录了手术时间和围手术期并发症以及患者的随访情况。
所有24例患者均行深部浸润型子宫内膜异位症切除术，5例患者附加膀胱切除术，8例患者附加结肠切除术，手术方式个体化。2例行中转开腹，1例患者行临时回肠造口术。未观察到严重的围手术期或术后并发症。中位手术时间为3.4小时（范围1.4 - 8.0小时）。所有膀胱受累患者的排尿功能障碍均得到缓解，除3例患者外，所有患者的疼痛问题均得到成功治疗，且这3例患者的症状也有所缓解。
深部浸润型子宫内膜异位症患者对手术操作构成挑战。我们的结果表明，包括结肠和膀胱切除术在内的根治性腹腔镜手术对几乎所有患者都是可行、安全且有效的。
