Intestinal endometriotic nodules with a length greater than 2.25 cm and affecting more than 27% of the circumference are more likely to undergo segmental resection, rather than linear nodulectomy

Autor: Helizabet Abdalla-Ribeiro, Marina Miyuki Maekawa, Raquel Ferreira Lima, Ana Luisa Alencar de Nicola, F.C. Rodrigues, Paulo A. Ribeiro
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Health Care Providers
Endometriosis
Diagnostic Radiology
Intestinal endometriosis
Gynecologic Surgical Procedures
Ultrasound Imaging
Medicine and Health Sciences
Medical Personnel
Intestinal Mucosa
Ultrasonography
Multidisciplinary
Radiology and Imaging
Middle Aged
Circumference
Professions
Treatment Outcome
Medicine
Female
Radiology
Anatomy
medicine.symptom
Segmental resection
Research Article
Adult
medicine.medical_specialty
Imaging Techniques
Science
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Lesion
Digestive System Procedures
Signs and Symptoms
Diagnostic Medicine
Physicians
medicine
Humans
Surgeons
Surgical Resection
Receiver operating characteristic
business.industry
Rectum
Biology and Life Sciences
Nodule (medicine)
medicine.disease
Gastrointestinal Tract
Health Care
Intestinal Diseases
Stenosis
Cross-Sectional Studies
People and Places
Lesions
Laparoscopy
Population Groupings
Intestinal Resection
Clinical Medicine
business
Digestive System
Zdroj: PLoS ONE, Vol 16, Iss 4, p e0247654 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Study objective To analyze the efficacy of intestinal ultrasonography with bowel preparation (TVUSBP) for endometriosis mapping in evaluating intestinal endometriosis to choose the surgical technique (segmental resection or linear nodulectomy) for treatment. Design Cross-sectional observational study. Setting University Hospital—Center for Advanced Endoscopic Gynecologic Surgery from April 2010 to November 2014. Patient(s) One hundred and eleven women with clinically suspected endometriosis and intestinal endometriotic nodule or intestinal adherence in TVUSBP for endometriosis mapping. Intervention(s) All patients with suspected endometriosis underwent TVUSBP for endometriosis mapping prior to videolaparoscopy for complete excision of endometriosis foci, including intestinal foci, using the linear nodulectomy or segmental resection techniques, depending on the characteristics of the intestinal lesion with confirmation of endometriosis on anatomopathological examination. Measurements and main results Preoperative ultrasonographic assessment of the length of the intestinal nodule, circumference of the intestinal loop affected by the endometriotic lesion, distance from the anal verge and intestinal wall layers infiltrated by endometriosis, as well as other endometriosis sites. Of the 111 patients who participated in the study, 63 (56.7%) presented intestinal endometriotic nodules in ultrasonography, performed by a single examiner (A.L.A.N.), and underwent intestinal surgical treatment of deep endometriosis—linear nodulectomy or segmental resection. The analysis of the receiver operating characteristic (ROC) curve showed that a longitudinal length of the intestinal nodule of 2.25 cm and a loop circumference of 27% are cutoff points separating linear nodulectomy from segmental resection techniques for excising intestinal endometriosis. The information obtained by TVUSBP helps the surgeon and patient, in the preoperative period, to select the surgical technique to be performed for resection of intestinal endometriosis and plan the surgical procedure while taking into account postoperative morbidity.
Databáze: OpenAIRE
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