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Standardization of endometriosis surgery - the coloproctologist's vision

Padronização da cirurgia da endometriose – visão do coloproctologista

ABSTRACT

Objective:

To demonstrate the standardization of deep endometriosis surgery with intestinal involvement.

Methods:

Prospective study evaluating 74 women undergoing standardized surgery for deep intestinal endometriosis. Divided into two groups, according to the findings of three-dimensional anorectal ultrasound, Group I with lesions affecting perirectal fat and Group II with lesions affecting at least the muscular layer of the rectum.

Results:

There was no statistically significant difference between the groups in relation to the size of the focus and the distance of the lesion to the puborectalis muscle (p > 0.05). The type of surgery performed was laparoscopy without lesions in one patient (1.35%), disk resection in 13 patients (17.56%), shaving in 45 patients (60.81%), and rectosigmoidectomy in 15 patients (20.27%). The complications were bleeding from the drain with conservative treatment in three patients (4.05%), fistula in two patients submitted to the shaving method (2.70%), and three patients (4.05%) with lower anterior recession syndrome (LARS), with improvement from conservative treatment. Lesions in other organs were also observed during videolaparoscopy.

Conclusion:

Surgical standardization is important to guide the general/colorectal surgeon in the effective approach of intestinal endometriosis.

Keywords:
Endometriosis; Ultrasonography; Laparoscopy; Colorectal surgery

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