Tratamiento multidisciplinario de la endometriosis profunda grave

Gonzalo Hugo  Zapata; Beatriz  Videla Rivero; Alejandro  Moreira Grecco; Leopoldo  Videla Rivero

doi:10.46768/racp.v31i04.82

Gonzalo Hugo Zapata MAAC, MSACP. Médico de planta del Hospital de Clínicas “José de San Martin”. Ciudad Autónoma de Buenos Aires, Argentina.
Beatriz Videla Rivero Miembro de SACIL. Ciudad Autónoma de Buenos Aires, Argentina.
Alejandro Moreira Grecco MAAC, MSACP. Médico de planta del Hospital de Clínicas “José de San Martin”. Ciudad Autónoma de Buenos Aires, Argentina.
Leopoldo Videla Rivero Miembro de SACIL, SOGIBA, AAGL, SLS, SIAEGI. Ciudad Autónoma de Buenos Aires, Argentina.

DOI: https://doi.org/10.46768/racp.v31i04.82

Keywords: Endometriosis, Laparoscopy, Treatment

Abstract

Introduction: Endometriosis is a clinical entity characterized by the presence of endometrial tissue from the endometrium, with the rectocolonic condition being the most aggressive.
Objectives: To evaluate the feasibility of colorectal resections, a complex pathology that must be addressed in a multidisciplinary way, and to report the results obtained from more than 10 years of work.
Design: single group retrospective.
Material and methods: Descriptive and retrospective study of case series, in a period between 2005 and early 2017. 29 patients were evaluated. The evaluation was carried out in a multidisciplinary way.
Results: We have operated 171 deep endometriosis, the mean age 34.04 years. 29 required resections of the colon, in 27 a previous resection was performed with colorectal anastomosis and 2 sigmoidectomies. The anastomoses were with mechanical suturing, 17 colorectal terminations and 12 lateral terminations. Twenty-eight anastomoses were performed between 7 and 5 cm from the anal margin, 1 was performed 4 cm from the anal margin. In this case, a transverse protective colostomy was made. The average operating time was 90 minutes (45-195). The conversion rate was 15%. Complications were hemoperitoneum, anastomotic fistula, and skin infections. The institutional stay the average was 5 days.
Conclusions: Laparoscopic treatment of this disease is factible, due to the distortion of the pelvic anatomy that it generates, although current trends emphasize the need to treat this condition in a minimally invasive way.