Daraï E, Touboul C, Chéreau E, Bazot M, Ballester M
Service de gynécologie-obstétrique, université Pierre et Marie Curie, hôpital Tenon, AP-HP, Paris 6, 4, rue de la Chine, 75020 Paris, France.
Gynecol Obstet Fertil. 2012 Feb;40(2):116-20. doi: 10.1016/j.gyobfe.2011.12.002. Epub 2012 Jan 26.
Colorectal surgery for endometriosis is increasingly performed, but its assessment is still incomplete, especially regarding its impact on quality of life, the recurrence rate and subsequent fertility. Segmental resection is the technique most often performed and best evaluated with a proven efficacy but associated with significant morbidity. Alternatives to segmental resection consisting of shaving rectal resection, discoid resection or superficial resection have recently been proposed to provide equivalent efficacy while decreasing morbidity. To date, data are insufficient to clarify the respective indications of segmental resection and alternatives. Only randomized trials will resolve the existing controversy.
子宫内膜异位症的结直肠手术开展得越来越多,但其评估仍不全面,尤其是在对生活质量、复发率及后续生育能力的影响方面。节段性切除是最常施行且评估最佳的技术,其疗效已得到证实,但会带来显著的发病率。最近有人提出节段性切除的替代方法,包括直肠削除术、盘状切除术或浅表切除术,以期在降低发病率的同时提供等效疗效。迄今为止,数据不足以阐明节段性切除及其替代方法各自的适应症。只有随机试验才能解决现有的争议。