Assessment of Long-Term Bowel Symptoms After Segmental Resection of Deeply Infiltrating Endometriosis: A Matched Cohort Study.

Soto, Enrique

Catenacci, Michelle

Bedient, Carrie

Jelovsek, J Eric

Falcone, Tommaso

United States

2017-08-01T13:30:50Z

2017-08-01T13:30:50Z

2016-07

STUDY OBJECTIVE: To assess long-term bowel symptoms in women who underwent segmental bowel resection for deep-infiltrating endometriosis (DIE) compared with women who underwent resection of severe endometriosis without bowel resection. DESIGN: Cohort study with matched controls (Canadian Task Force classification II-2). SETTING: Cleveland Clinic. PATIENTS: 71 patients (36 cases and 35 controls). INTERVENTIONS: Patients who were at least 4 years out from undergoing segmental bowel resection due to DIE were matched with patients who had undergone resection of stage III/IV endometriosis without bowel resection. The patients completed validated questionnaires, and data were analyzed using the Wilcoxon rank-sum, χ(2), and Fisher exact tests. MEASUREMENTS AND MAIN RESULTS: The Bristol Stool Form Scale, Patient Assessment of Constipation Symptoms Questionnaire (PAC-SYM), and St Mark's Vaizey Fecal Incontinence Grading System were used to elicit information. The median duration of follow-up was 10.1 years (range, 4-18 years). The mean patient age and body mass index were comparable in the cases and the controls. A larger proportion of cases than controls reported new bowel symptoms (58% [21 of 36] vs 14% [5 of 35]; p = .001), as well as abdominal pain, incomplete bowel movements, and false alarms on the PAC-SYM questionnaire; however, total PAC-SYM and Vaizey Fecal Incontinence Grading System scores were similar in the 2 groups (median, 8 [interquartile range, 8-10] vs 8 [8-10]; p = .86). Similarly, the proportion of patients with normal stool consistency (Bristol Stool Form Scale score 2-6) was similar in the 2 groups (80.6% [29 of 36] vs 94.3% [33 of 35]; p = .59). CONCLUSION: Segmental bowel resection for DIE may be associated with a higher incidence of new bowel symptoms (possibly due to abdominal pain, incomplete bowel movements, and/or false alarms), but not with worse constipation or fecal incontinence, compared with surgery without bowel resection.

https://www.ncbi.nlm.nih.gov/pubmed/26976198

S1553-4650(16)00138-2

1553-4669

https://hdl.handle.net/10161/15124

eng

Elsevier BV

J Minim Invasive Gynecol

10.1016/j.jmig.2016.03.004

Constipation

Deep infiltrating endometriosis

Fecal incontinence

Segmental bowel resection

Severe endometriosis

Adult

Case-Control Studies

Cohort Studies

Constipation

Diarrhea

Digestive System Surgical Procedures

Dysmenorrhea

Endometriosis

Fecal Incontinence

Female

Follow-Up Studies

Gastrointestinal Hemorrhage

Humans

Intestinal Diseases

Postoperative Complications

Retrospective Studies

Surveys and Questionnaires

Treatment Outcome

Assessment of Long-Term Bowel Symptoms After Segmental Resection of Deeply Infiltrating Endometriosis: A Matched Cohort Study.

Journal article

Jelovsek, J Eric|0000-0002-7196-817X

https://www.ncbi.nlm.nih.gov/pubmed/26976198

753

759

5

Clinical Science Departments

Duke

Obstetrics and Gynecology

Obstetrics and Gynecology, Urogynecology

School of Medicine

Published

23