Minimally Invasive Gynecology Research Group, Department of Ob/Gyn and Newborn Care, University of Ottawa & the Ottawa Hospital, 501 Smyth Rd, K1H 8L6, Ottawa ON Canada.
Minimally Invasive Gynecology Research Group, Department of Ob/Gyn and Newborn Care, University of Ottawa & the Ottawa Hospital, 501 Smyth Rd, K1H 8L6, Ottawa ON Canada; Ottawa Hospital Research Institute, Department of Clinical Epidemiology, 1053 Carling Ave, K1Y 4E9, Ottawa ON Canada.
Best Pract Res Clin Obstet Gynaecol. 2021 Mar;71:144-160. doi: 10.1016/j.bpobgyn.2020.06.003. Epub 2020 Jun 18.
Endometriosis involving the bowel requires a thorough evaluation prior to deciding upon surgical treatment. Patient symptoms, treatment goals, extent and location of disease, surgeon experience, and anticipated risks all play a part in the preoperative decision-making process. Short- and long-term complications after bowel surgery for endometriosis are the focus of this article. Unfortunately, the literature to date has inherent limitations that prevent generalizability. Most studies are retrospective or prospective single-center case series. Publication bias is unavoidable with mainly large volume experts sharing their experience. As a result, there is a need for high-quality prospective studies that standardize inclusion criteria and outcome measures among various centers with an aim to present long-term outcomes. In the meantime, care for those with endometriosis involving the bowel requires a thorough preoperative plan to minimize risks and a need for early diagnosis and management of complications unique to bowel surgery.
肠子宫内膜异位症需要在决定手术治疗前进行彻底评估。患者症状、治疗目标、疾病的范围和位置、外科医生的经验以及预期风险都在术前决策过程中发挥作用。本文重点介绍肠子宫内膜异位症手术后的短期和长期并发症。不幸的是,迄今为止的文献存在内在局限性,无法推广。大多数研究是回顾性或前瞻性的单中心病例系列。由于主要是大容量的专家分享他们的经验,因此不可避免地存在发表偏倚。因此,需要进行高质量的前瞻性研究,在各个中心之间标准化纳入标准和结果测量,旨在呈现长期结果。同时,对于涉及肠道的子宫内膜异位症患者,需要进行彻底的术前计划,以最大限度地降低风险,并需要早期诊断和处理肠道手术特有的并发症。