Minimally Invasive Gynecological Surgery Unit, Reproductive Medicine Unit, S. Orsola Hospital, University of Bologna, Italy.
Fertil Steril. 2010 Feb;93(3):1007.e1-3. doi: 10.1016/j.fertnstert.2009.09.058. Epub 2009 Nov 25.
To present a case of complicated deep infiltrating endometriosis managed by a multidisciplinary minimally invasive approach.
Case report.
Tertiary care university hospital.
A 32-year-old woman with deep infiltrating endometriosis involving the rectovaginal septum, the rectum, and the left ureter, complicated by silent left renal function loss.
INTERVENTION(S): Laparoscopic left nephrectomy, ureterectomy, excision of a left ovarian endometrioma, removal of a large rectovaginal nodule, and segmental bowel resection with minilaparotomic end-to-end anastomosis.
MAIN OUTCOME MEASURE(S): Multidisciplinary diagnosis and minimally invasive surgical approach to deep infiltrating endometriosis involving the rectum and the urinary tract.
RESULT(S): Collaboration between gynecologists, urologists, and colorectal surgeons enabled a successful management of the case in one surgical intervention providing minor risk of complications, shorter hospital stay, and faster functional recovery.
CONCLUSION(S): Deep infiltrating endometriosis is a global pathology that may involve different structures. A multidisciplinary, minimally invasive approach should be recommended to achieve appropriate disease management.
介绍一例采用多学科微创方法治疗的复杂深部浸润性子宫内膜异位症病例。
病例报告。
三级保健大学医院。
一名 32 岁女性，患有累及直肠阴道隔、直肠和左侧输尿管的深部浸润性子宫内膜异位症，伴有左侧肾功能丧失。
腹腔镜左肾切除术、输尿管切除术、左侧卵巢子宫内膜异位囊肿切除术、直肠阴道大结节切除术和小肠节段切除术，并采用迷你剖腹肠端对端吻合术。
多学科联合诊断和微创方法治疗累及直肠和泌尿道的深部浸润性子宫内膜异位症。
妇科医生、泌尿科医生和结直肠外科医生的协作，使得在一次手术干预中成功治疗了该病例，降低了并发症的风险、缩短了住院时间并加快了功能恢复。
深部浸润性子宫内膜异位症是一种全球性疾病，可能累及不同的结构。应推荐多学科微创方法来实现对疾病的适当管理。
