Laparoscopic management of bowel endometriosis: resection margins as a predictor of recurrence. (17th September 2014)

• Record Type: Journal Article
• Authors: Nirgianakis, Konstantinos; McKinnon, Brett; Imboden, Sara; Knabben, Laura; Gloor, Beat; Mueller, Michael D.
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 12(2014)
• Page Start: 1262
• Page End: 1267
• Publication Date: 2014-09-17
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12490
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12490-abs-0001"> <title>Abstract</title> <sec id="aogs12490-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate possible predictive factors for recurrence after laparoscopic segmental bowel resection for bowel endometriosis.</p> </sec> <sec id="aogs12490-sec-0002" sec-type="section"> <title>Design</title> <p>Cohort study.</p> </sec> <sec id="aogs12490-sec-0003" sec-type="section"> <title>Setting</title> <p>Academic tertiary referral center.</p> </sec> <sec id="aogs12490-sec-0004" sec-type="section"> <title>Methods</title> <p>95 symptomatic women with bowel endometriosis who underwent laparoscopic segmental bowel resection at the Endometriosis clinic, University of Berne, between 2002 and 2012 were enrolled. Since 14 women were lost to follow‐up, 81 formed the final cohort. Clinical and histological characteristics were examined as possible predictive factors for disease recurrence.</p> </sec> <sec id="aogs12490-sec-0005" sec-type="section"> <title>Main outcome measures</title> <p>Recurrence, defined as a subsequent operation due to recurrent endometriosis‐associated pain with a histologically confirmed endometriotic lesion.</p> </sec> <sec id="aogs12490-sec-0006" sec-type="section"> <title>Results</title> <p>Recurrence was observed in 13 (16%) patients. Variables that were significantly associated to recurrence by the Cox regression analysis were positive bowel resection margins (hazard ratio 6.5, 95% confidence interval 1.8–23.5, <italic>p</italic> = 0.005), age <31 years (hazard ratio 5.6, 95% confidence interval 1.7–18.6, <italic>p </italic>=<italic> </italic>0.005) and body mass index ≥23 kg/m<sup>2</sup> (hazard ratio 11.0, 95% confidence interval 2.7–44.6, <italic>p</italic> = 0.001).</p> </sec> <sec id="aogs12490-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Positive bowel resection margins as well as age <31 years and body mass index ≥23 kg/m<sup>2</sup> appear to be independent predictors of disease recurrence.</p> </sec> </abstract>