Department of Obstetrics and Gynecology, Policlinico Hospital, Abano Terme, Padua, Italy.
Department of Surgical Oncology, Robotics and New Technologies, Policlinico Hospital, Abano Terme, Padua, Italy.
Sci Rep. 2022 Feb 24;12(1):3146. doi: 10.1038/s41598-022-07237-w.
Laparoscopic rectosigmoid resection for endometriosis is usually performed with the section of the inferior mesenteric artery (IMA) distal to the left colic artery (low-tie ligation). This study was to determine outcomes in IMA-sparing surgery in endometriosis cases. A single-center retrospective study based on the analysis of clinical notes of women who underwent laparoscopic rectosigmoid segmental resection and IMA-sparing surgery for deep infiltrating endometriosis with bowel involvement between March the 1st, 2018 and February the 29th, 2020 in a referral hospital. During the study period, 1497 patients had major gynecological surgery in our referral center, of whom 253 (17%) for endometriosis. Of the 100 patients (39%) who had bowel endometriosis, 56 underwent laparoscopic nerve-sparing rectosigmoid segmental resection and IMA-sparing surgery was performed in 53 cases (95%). Short-term complications occurred in 4 cases (7%) without any case of anastomotic leak. Preservation of the IMA in colorectal surgery for endometriosis is feasible, safe and enables a tension-free anastomosis without an increase of postoperative complication rates.
腹腔镜直肠乙状结肠切除术治疗子宫内膜异位症通常在左结肠动脉（左结肠动脉）下方结扎肠系膜下动脉（IMA）。本研究旨在确定子宫内膜异位症病例中保留 IMA 的手术结果。这是一项单中心回顾性研究，基于对 2018 年 3 月 1 日至 2020 年 2 月 29 日期间在一家转诊医院接受腹腔镜直肠乙状结肠节段切除术和保留 IMA 的手术治疗深部浸润性子宫内膜异位症伴肠受累的女性的临床记录进行分析。在研究期间，我们的转诊中心有 1497 名女性接受了主要妇科手术，其中 253 名（17%）为子宫内膜异位症患者。在 100 名（39%）患有肠子宫内膜异位症的患者中，56 名患者接受了腹腔镜神经保留直肠乙状结肠节段切除术，53 名患者（95%）进行了保留 IMA 的手术。4 例（7%）发生短期并发症，无吻合口漏。在结直肠手术中保留 IMA 是可行的、安全的，可以实现无张力吻合，而不会增加术后并发症的发生率。
