Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark.
Department of Obstetrics and Gynecology, Herlev University Hospital, Copenhagen, Denmark.
Dis Colon Rectum. 2018 Feb;61(2):221-229. doi: 10.1097/DCR.0000000000000970.
Surgery for rectosigmoid endometriosis carries a substantial risk of short- and long-term complications, which has to be counterbalanced against the potential effect of the procedure. Prospective data are scarce in the field of deep infiltrating endometriosis surgery.
The study aimed to assess pelvic pain and quality of life before and after laparoscopic bowel resection for rectosigmoid endometriosis.
The study involved prospectively collected data regarding pelvic pain and quality of life before and after surgery.
It was conducted at a tertiary endometriosis referral unit at Aarhus University Hospital.
A total of 175 women were included.
Patients underwent laparoscopic bowel resection for endometriosis.
Questionnaires for pain (Numerical Rating Scale) and quality of life (RAND Short Form-36) were answered before and 1 year after surgery. Data on analgesic and hormone treatment were collected. Preoperative and postoperative pelvic pain and quality-of-life scores were compared, and risk factors for improvement/worsening were identified.
A total of 97.1% of the women completed the 1-year follow up. A significant decrease (p = 0.0001) was observed on all pelvic pain parameters. Most profound was the decrease in dyschezia. A significant improvement on all quality-of-life scores was observed (p = 0.0001). A surgical complication did not have a negative impact on outcome 1 year after surgery. The postoperative outcome was not related to the type of surgery.
This is an observational study without a control group. Risk factor data should be interpreted with caution, because the study was relatively underpowered for some of the rare outcomes.
A significant and clinically relevant improvement in pelvic pain and quality of life 1 year after laparoscopic bowel resection for endometriosis was found. We strongly recommend surgery for rectosigmoid endometriosis that is unresponsive to conservative treatment. See Video Abstract at http://links.lww.com/DCR/A472.
直肠乙状结肠子宫内膜异位症的手术存在短期和长期并发症的巨大风险，这必须与手术的潜在效果相平衡。在深部浸润性子宫内膜异位症手术领域，前瞻性数据稀缺。
本研究旨在评估腹腔镜肠切除术治疗直肠乙状结肠子宫内膜异位症前后的盆腔疼痛和生活质量。
本研究前瞻性收集了手术前后盆腔疼痛和生活质量的数据。
在奥胡斯大学医院的三级子宫内膜异位症转诊单位进行。
共纳入 175 名女性。
患者接受腹腔镜肠切除术治疗子宫内膜异位症。
手术前后使用数字评分量表（Numerical Rating Scale）和 RAND 短期健康调查问卷 36 项版（RAND Short Form-36）评估疼痛和生活质量。收集了镇痛和激素治疗的数据。比较了术前和术后盆腔疼痛和生活质量评分，并确定了改善/恶化的危险因素。
共有 97.1%的女性完成了 1 年的随访。所有盆腔疼痛参数均显著下降（p = 0.0001）。最明显的是排便困难的减轻。所有生活质量评分均显著改善（p = 0.0001）。手术并发症对术后 1 年的结果没有负面影响。术后结果与手术类型无关。
这是一项没有对照组的观察性研究。风险因素数据的解释应谨慎，因为对于一些罕见的结局，该研究的效力相对较低。
腹腔镜肠切除术治疗直肠乙状结肠子宫内膜异位症后 1 年，盆腔疼痛和生活质量显著且具有临床意义的改善。我们强烈建议对保守治疗无效的直肠乙状结肠子宫内膜异位症进行手术。详见视频摘要，网址：http://links.lww.com/DCR/A472。
