Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria.
Institute for Pathology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
Eur J Med Res. 2021 Jan 23;26(1):12. doi: 10.1186/s40001-021-00484-z.
Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis.
Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome.
Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54).
Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.
子宫内膜异位症与大量慢性盆腔疼痛和生活质量下降有关。在子宫内膜异位症累及肠道的情况下进行结肠直肠切除术,会给年轻和健康的患者带来不可忽视的发病率。症状的严重程度与子宫内膜异位症的分期之间没有建立线性相关性。本研究的目的是将组织学发现与接受结肠直肠切除术的子宫内膜异位症患者的术前疼痛评分相关联。
回顾性分析 2014 年至 2019 年间接受腹腔镜结肠直肠切除术治疗子宫内膜异位症的 25 例患者。2020 年 5 月通过电话对术前和术后疼痛水平进行评估。组织病理学与术前症状和术后结果相关联。
平均随访时间为 38.68 个月(±19.92)。术前 VAS 评分为 8.32(±1.70)。我们观察到所有患者手术后疼痛水平均显著降低(p≤0.005)。卫星灶的存在和不同程度的浸润深度与疼痛水平无关。所有患者的切除边缘均清晰。6 例(24%)发生术后并发症,3 例(12%)发生吻合口漏。随访时平均 VAS 评分为 1.70(±2.54)。
我们的数据表明,无论组织病理学发现如何,充分的结肠直肠切除术可减轻疼痛并提高生活质量。需要有经验的团队来改善手术中的结果,并在发生并发症的情况下降低术后发病率。