Nerve-sparing laparoscopic disc excision of deep endometriosis involving the bowel: a single-center experience on 371 co
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and Other Interventional Techniques
Nerve‑sparing laparoscopic disc excision of deep endometriosis involving the bowel: a single‑center experience on 371 consecutives cases Marcello Ceccaroni1 · Matteo Ceccarello1 · Roberto Clarizia1 · Enrico Fusco2 · Giovanni Roviglione1 · Daniele Mautone1 · Camilla Cavallero1,3 · Simone Orlandi4 · Roberto Rossini5 · Giuliano Barugola5 · Giacomo Ruffo5 Received: 16 April 2020 / Accepted: 3 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Bowel endometriosis is the most common pattern of Deep Endometriosis (DE). Arising from the posterior portion of the cervix and spreading to the recto-vaginal septum, utero-sacral and parametrial ligaments could lead to a distortion of normal pelvic anatomy, causing pain and infertility. Hormonal therapy is the first-line treatment in non-symptomatic patient. Conversely, laparoscopic surgical treatment has to be considered when symptoms relief are not optimal or with signs of bowel occlusion. Methods Retrospective experience of consecutive series of patients who referred to a third-level referral center with suspected bowel DE and failure of multiple medical treatments. After an intraoperative evaluation of nodule size with a rectal shaving of its external portion, patients underwent radical DE eradication with concomitant disc excision in rectal nodules
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