Ip Julian C Y, Chua Terence C, Wong Shing W, Krishnan Surya
Department of Surgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2020 Jun;60(3):454-458. doi: 10.1111/ajo.13145. Epub 2020 Mar 11.
Gastrointestinal symptoms occur with deeply infiltrating endometriosis (DIE) of the rectum.
To explore the medium-term gastrointestinal functional outcomes after rectal disc resection for endometriosis.
All women undergoing laparoscopy for stage IV endometriosis at a tertiary referral hospital between November 2016 and January 2018 and had evidence of DIE of the rectum were included. Low anterior resection syndrome (LARS) score was measured using a validated questionnaire.
Thirty-six women formed the cohort of the study. The mean age was 37 years (range 20-72 years). All women underwent a laparoscopic anterior rectal disc resection for DIE. The response rate was 100%. There was an increase in the percentage of patients having no LARS postoperatively compared to preoperatively (an increase of 78-83%). There was a reduction in LARS scores postoperatively observed in 18 patients (50%) and the prevalence of major LARS decreased postoperatively from 10% to 1%. Comparison of individual symptoms revealed a significant improvement in postoperative stool frequency scores (P = 0.02). Multivariate analysis using logistic regression analysis demonstrated that reduction in postoperative stool frequency scores remained an independent factor (P = 0.008).
Rectal disc resection is feasible and safe, achieving observable improvements in stool frequency in patients with rectal DIE.
直肠深部浸润型子宫内膜异位症(DIE)会出现胃肠道症状。
探讨直肠盘状切除术治疗子宫内膜异位症后的中期胃肠道功能结局。
纳入2016年11月至2018年1月在一家三级转诊医院接受腹腔镜检查的所有IV期子宫内膜异位症患者,且这些患者有直肠DIE的证据。使用经过验证的问卷测量低位前切除综合征(LARS)评分。
36名女性组成了研究队列。平均年龄为37岁(范围20 - 72岁)。所有女性均接受了腹腔镜直肠前盘状切除术治疗DIE。应答率为100%。与术前相比,术后无LARS的患者百分比有所增加(增加了78 - 83%)。18名患者(50%)术后LARS评分降低,主要LARS的患病率从10%降至1%。对个体症状的比较显示,术后大便频率评分有显著改善(P = 0.02)。使用逻辑回归分析的多变量分析表明,术后大便频率评分的降低仍然是一个独立因素(P = 0.008)。
直肠盘状切除术可行且安全,可使直肠DIE患者的大便频率得到明显改善。