安全可行的直肠乙状结肠子宫内膜异位症节段性切除的单中心经验

A. Nugroho, R. Saunar, Indah Jamtani, M. L. Syahbana, Syamsu Hudaya, A. Widarso, T. Poniman
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摘要

肠内膜异位症,定义为子宫内膜组织浸润肠固有肌层及以上(3),以乙状结肠和直肠为主。我们在时间线内收集了170例子宫内膜异位症,其中47例(27%)诊断为死亡。深浸润性子宫内膜异位症(Deep浸润性Endometriosis, DIE)累及肠道,包括仅累及直肠周围脂肪和直肠浆膜19例(40%);11例(58%)死亡浸润过直肠浆膜。共有8例(42%)仅直肠周围脂肪和直肠浆膜受累的病例被排除在本研究之外。我们描述了9例经节段性切除术和原发性妇科切除术治疗的直肠死亡患者的临床特征。综上所述,即使采用微创技术,节段性切除术也是安全可行的,可纳入肠内膜异位症的综合多学科治疗。进一步努力扩大其使用是必要的,以增加全国范围内肠子宫内膜异位症的管理范围。
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Single Center Experience of a Safe and Feasible Segmental Resection of Rectosigmoid Endometriosis
Bowel endometriosis, defined as presence of endometrial tissue infiltrating the intestinal muscularis propria layer and beyond (3), has a sigmoid colon and rectal predilection. We collected 170 cases of endometriosis within the timeline, out of which DIE was diagnosed in 47 cases (27%). Deep Infiltrating Endometriosis (DIE) that effected the bowel, including those that only effected the perirectal fat and rectal serosa were 19 cases (40%); 11 cases (58%) had DIE infiltrating past the rectal serosa. A total of 8 cases (42%), with only perirectal fat and rectal serosa involvement were treated with either disc excision or shaving, were excluded from this study We described the clinical characteristics of 9 patients with rectal DIE that were treated with Segmental Resection along with primary gynecological resection. In summary, Segmental resection is safe and feasible, even with minimally invasive technique, to be incorporated in the comprehensive multidisciplinary management of bowel endometriosis. Further effort to expand its use is necessary to increase the scope of bowel endometriosis management across the country.
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