Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases

Deep endometriosis infiltrating the rectum remains a challenging situation to manage, and it is even more important when ureters and pelvic nerves are also infiltrated. Removal of deep rectovaginal endometriosis is mandatory in case of symptoms strongly impairing quality of life, alteration of diges...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autor principal:	Olivier Donnez
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	deep endometriosis surgery shaving surgical outcomes complications recurrence Medicine R
Acceso en línea:	https://doaj.org/article/2ef3cde1dba44557a5c0327039a1a75f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2ef3cde1dba44557a5c0327039a1a75f
record_format	dspace
spelling	oai:doaj.org-article:2ef3cde1dba44557a5c0327039a1a75f2021-11-11T17:47:34ZConservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases10.3390/jcm102151832077-0383https://doaj.org/article/2ef3cde1dba44557a5c0327039a1a75f2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5183https://doaj.org/toc/2077-0383Deep endometriosis infiltrating the rectum remains a challenging situation to manage, and it is even more important when ureters and pelvic nerves are also infiltrated. Removal of deep rectovaginal endometriosis is mandatory in case of symptoms strongly impairing quality of life, alteration of digestive, urinary, sexual and reproductive functions, or in case of growing. Extensive preoperative imaging is required to choose the right technique between laparoscopic shaving, disc excision, or rectal resection. When performed by skilled surgeons and well-trained teams, a very high majority of cases of deep endometriosis nodule (>95%) is feasible by the shaving technique, and this is associated with lower complication rates regarding rectal resection. In most cases, removing a part of the rectum is questionable according to the risk of complications, and the rectum should be preserved as far as possible. Shaving and rectal resection are comparable in terms of recurrence rates. As shaving is manageable whatever the size of the lesions, surgeons should consider rectal shaving as first-line surgery to remove rectal deep endometriosis. Rectal stenosis of more than 80% of the lumen, multiple bowel deep endometriosis nodules, and stenotic sigmoid colon lesions should be considered as indication for rectal resection, but this represents a minority of cases.Olivier DonnezMDPI AGarticledeep endometriosissurgeryshavingsurgical outcomescomplicationsrecurrenceMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5183, p 5183 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	deep endometriosis surgery shaving surgical outcomes complications recurrence Medicine R
spellingShingle	deep endometriosis surgery shaving surgical outcomes complications recurrence Medicine R Olivier Donnez Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
description	Deep endometriosis infiltrating the rectum remains a challenging situation to manage, and it is even more important when ureters and pelvic nerves are also infiltrated. Removal of deep rectovaginal endometriosis is mandatory in case of symptoms strongly impairing quality of life, alteration of digestive, urinary, sexual and reproductive functions, or in case of growing. Extensive preoperative imaging is required to choose the right technique between laparoscopic shaving, disc excision, or rectal resection. When performed by skilled surgeons and well-trained teams, a very high majority of cases of deep endometriosis nodule (>95%) is feasible by the shaving technique, and this is associated with lower complication rates regarding rectal resection. In most cases, removing a part of the rectum is questionable according to the risk of complications, and the rectum should be preserved as far as possible. Shaving and rectal resection are comparable in terms of recurrence rates. As shaving is manageable whatever the size of the lesions, surgeons should consider rectal shaving as first-line surgery to remove rectal deep endometriosis. Rectal stenosis of more than 80% of the lumen, multiple bowel deep endometriosis nodules, and stenotic sigmoid colon lesions should be considered as indication for rectal resection, but this represents a minority of cases.
format	article
author	Olivier Donnez
author_facet	Olivier Donnez
author_sort	Olivier Donnez
title	Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
title_short	Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
title_full	Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
title_fullStr	Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
title_full_unstemmed	Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
title_sort	conservative management of rectovaginal deep endometriosis: shaving should be considered as the primary surgical approach in a high majority of cases
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2ef3cde1dba44557a5c0327039a1a75f
work_keys_str_mv	AT olivierdonnez conservativemanagementofrectovaginaldeependometriosisshavingshouldbeconsideredastheprimarysurgicalapproachinahighmajorityofcases
_version_	1718431993158434816

Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases

Ejemplares similares