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Comparison of Laparoscopic Anterior Discoid Resection and Laparoscopic Low Anterior Resection of Deep Infiltrating Rectosigmoid Endometriosis
- Source :
- JSLS : Journal of the Society of Laparoendoscopic Surgeons
- Publication Year :
- 2011
- Publisher :
- Society of Laparoendoscopic Surgeons, 2011.
-
Abstract
- Anterior discoid resection is associated with a shorter operative time, lower blood loss, shorter hospital stay, and lower rate of anastomotic strictures than laparoscopic anterior resection is in the treatment of rectal endometriosis.<br />Objective: To compare laparoscopic anterior discoid resection (ADR) with low anterior resection (LAR). Methods: This is a retrospective review of a cohort (Canadian Task Force classification II-2) of patients undergoing laparoscopic ADR or LAR at a university hospital. Chart review and telephone questionnaires were conducted to examine long-term outcomes. Preoperative and operative findings, short- and long-term outcomes were compared. SF-12 quality of life scores, need for further interventions, and overall satisfaction were also compared. Results: Twenty-two patients underwent laparoscopic ADR (n=8) or LAR (n=14) for rectosigmoid endometriosis between January 2001 and December 2009. Mean follow-up time was 41.26 months (range, 14 to 70). Patients undergoing laparoscopic ADR had significantly less blood loss and shorter operative time and hospital stay. Patients who required LAR had a significantly higher rate of mucosal involvement (61.5% v. 0%). No statistically significant difference was found in the size, depth of invasion, location of lesions, or operative complications. Fifty percent of the LAR group had several lesions as opposed to 12.5% of the ADR group. Median age was significantly higher in patients who required LAR (39) than in patients who required ADR (32). Three patients in the LAR group (21.4%) had anastomotic strictures; 2 required dilation. The ADR group had consistently higher increments of improvement in bowel symptoms and dyspareunia. Overall satisfaction rate with the procedures was 93.3%. SF-12 scores were comparable between the 2 groups. Conclusion: ADR compared with LAR is associated with decreased operative time, blood loss, and hospital stay and a lower rate of anastomotic strictures. Other outcomes and satisfaction rates are comparable between the 2 procedures.
- Subjects :
- Adult
medicine.medical_specialty
Anastomosis
Endometriosis
Blood Loss, Surgical
Resection
03 medical and health sciences
0302 clinical medicine
Gynecologic Surgical Procedures
Blood loss
medicine
Scientific Papers
Humans
Retrospective Studies
030219 obstetrics & reproductive medicine
Low Anterior Resection
Sigmoid Diseases
business.industry
Length of Stay
medicine.disease
University hospital
3. Good health
Surgery
Rectal Diseases
Treatment Outcome
Satisfaction rate
030220 oncology & carcinogenesis
Cohort
Quality of Life
Laparoscopy
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 19383797 and 10868089
- Volume :
- 15
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- JSLS : Journal of the Society of Laparoendoscopic Surgeons
- Accession number :
- edsair.doi.dedup.....a70b96077adf9401fddb9cd1f28d9712