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Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection

  • Jordan S. Klebanoff , Whitney A. Barnes , Katherine Denny , Marissa G. Mangini , Jamil Kazma , Antonio Simone Laganà , Nassir Habib , Jean Marc Ayoubi and Gaby N. Moawad ORCID logo EMAIL logo
Published/Copyright: February 19, 2021
Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 43 Issue 2

Abstract

Endometriosis is a complex chronic inflammatory condition that can create a multitude of bothersome painful symptoms for women. Bowel endometriosis is often misdiagnosed or overlooked leading to years of suffering for many women. The surgical management of bowel endometriosis varies based on extent of disease as well as surgeon experience. Surgical treatment for bowel endometriosis is complex and a variety of intraoperative and postoperative complications must be considered. Two significant postoperative complications for bowel endometriosis include anastomotic leak and fistula formation. There is continued debate regarding the appropriate surgical treatment for bowel endometriosis. Aggressive surgery with segmental bowel resection is being utilized more cautiously, with an increase in less aggressive shaving or disc excision techniques. Historic beliefs regarding the limitations of shaving and disc excision are being challenged, and with a reduction in morbidity these less aggressive techniques are winning favor among gynecologic surgeons. Shaving, discoid excision, and segmental bowel resection are all feasible surgical management options for bowel endometriosis. Segmental resection is associated with the highest rates of both anastomotic leak and fistula formation, while shaving is associated with the lowest.

Keywords: bowel shaving; disc excision; endometriosis; segmental resection; surgical management
Corresponding author: Gaby N. Moawad, MD, Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecology, The George Washington University Hospital, 2150 Pennsylvania Ave NW, Washington, DC 20037, USA, E-mail:

  1. Research funding: Authors state no funding involved.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Dr. Moawad is a speaker for Intuitive Surgical. No other conflicts of interest declared.

  4. Informed consent: Informed consent is not applicable.

  5. Ethical approval: The conducted research is not related to either human or animals use.

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Received: 2020-09-16
Accepted: 2021-02-03
Published Online: 2021-02-19

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
  4. The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
  5. A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
  6. Appropriate surgical management of ovarian endometrioma: excision or drainage?
  7. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
  8. Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
  9. Endometriosis at all ages: diagnostic ultrasound
  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
  11. Opinion Paper
  12. Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
  13. Review Articles
  14. Fertility preservation in women with early ovarian cancer
  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
  16. Fertility preservation in borderline ovarian tumor patients and survivors
  17. Regular Issue
  18. Original Articles
  19. Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
  20. miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
  21. Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
  22. The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
  23. Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
  24. The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
  25. Review Articles
  26. What is the optimal luteal support in assisted reproductive technology?
  27. The relation between obesity, kisspeptin, leptin, and male fertility
https://doi.org/10.1515/hmbci-2020-0065
Keywords for this article
bowel shaving; disc excision; endometriosis; segmental resection; surgical management

Articles in the same Issue

  1. Frontmatter
  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
  4. The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
  5. A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
  6. Appropriate surgical management of ovarian endometrioma: excision or drainage?
  7. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
  8. Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
  9. Endometriosis at all ages: diagnostic ultrasound
  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
  11. Opinion Paper
  12. Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
  13. Review Articles
  14. Fertility preservation in women with early ovarian cancer
  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
  16. Fertility preservation in borderline ovarian tumor patients and survivors
  17. Regular Issue
  18. Original Articles
  19. Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
  20. miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
  21. Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
  22. The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
  23. Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
  24. The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
  25. Review Articles
  26. What is the optimal luteal support in assisted reproductive technology?
  27. The relation between obesity, kisspeptin, leptin, and male fertility
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