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Gkrozou F, Tsonis O, Sorrentino F, Nappi L, Vatopoulou A, Skentou C, Pandey S, Paschopoulos M, Daniilidis A. Endometriosis Predictive Models Based on Self-Assessment Questionnaire, Evidence from Clinical Examination or Imaging Findings: A Narrative Review. J Clin Med 2024; 13:356. [PMID: 38256490 PMCID: PMC10816076 DOI: 10.3390/jcm13020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE The aim of this narrative review is to evaluate existing questionnaires on predictive models for endometriosis. These symptom-based models have the potential to serve as screening tools for adult women to detect endometriosis. DATA SOURCES A comprehensive search of PubMed and Embase databases was conducted to identify studies on endometriosis screening. SELECTION OF STUDIES The search targeted predictive models for endometriosis localisation, bowel involvement, need for bowel surgery and fertility. Due to the heterogeneity identified, a systematic review was not possible. A total of 23 studies were identified. DATA EXTRACTION AND SYNTHESIS Among these studies, twelve included measures for general endometriosis, two targeted specific sites, four focused on deep infiltrating endometriosis (DIE), and three addressed the need for endometriosis-related bowel surgery. Many measures combined clinical, imaging and laboratory tests with patient questionnaires. Validation of these models as screening tools was lacking in all studies, as the focus was on diagnosis rather than screening. CONCLUSION This review did not identify any fully validated, symptom-based questionnaires for endometriosis screening in adult women. Substantial validation work remains to establish the efficacy of such tools.
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Affiliation(s)
- Fani Gkrozou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Orestis Tsonis
- Assisted Conception Unit, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 9RT, UK;
- Department of Gynaecology, St George’s University Hospitals NHS Foundation Trust, London WC1E 6BT, UK;
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy;
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy;
| | - Anastasia Vatopoulou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Chara Skentou
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Suruchi Pandey
- Department of Gynaecology, St George’s University Hospitals NHS Foundation Trust, London WC1E 6BT, UK;
| | - Minas Paschopoulos
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, 451 10 Ioannina, Greece; (F.G.); (C.S.); (M.P.)
| | - Angelos Daniilidis
- 2nd Department of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Karimi R, Poupon C, Du Cheyron J, Paternostre A, Fauconnier A. [Performance of an Ultrasound Based Endometriosis Staging System (UBESS) for predicting rectal involvement and type of surgical procedure in patients with digestive endometriosis]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:359-366. [PMID: 37080293 DOI: 10.1016/j.gofs.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Preoperative assessment of rectal damage in digestive endometriosis requires rectal endoscopic ultra-sonography an invasive exam that is not well received by the patients. A standardized approach using an Ultrasound-Based Endometriosis Staging System (UBESS)could be an interesting tool in this indication. This article aims to evaluate the performance of UBESS in the prediction of rectal involvement and the type of surgical procedure. MATERIALS AND METHODS This monocentric retrospective study was conducted on patients with rectal endometriosis who underwent a curative surgical procedure, evaluated by UBESS ultrasound between January 2016 and December 2019 at the Poissy referral centre. The main analysis of the study was to assess the adequacy of the UBESS ultrasound stage, the presence of rectal involvement during surgery and the surgical technique required. The secondary objective was to determine the correlation between UBESS stages and RCOG levels of surgical difficulty. RESULTS A total of one hundred and twenty-two patients were included and one hundred were analysed. Of these, thirty-nine had rectal involvement. There was a statistically significant association between the UBESS stage and the presence of a digestive lesion(P<0.0001). The ultrasound's parameters of thickness(P=0.0007), width(P=0.0082) and volume(P=0.0013) of the digestive lesion were significantly correlated with the extent of the surgical procedure. The correlation between the UBESS and RCOG classifications was very weak. CONCLUSION UBESS is a powerful diagnostic tool for digestive damage allowing to give clear information to patients before surgery and optimizing the management plan of the surgery.
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Affiliation(s)
- Rajae Karimi
- Service de chirurgie gynécologique et obstétrique de Poissy-Saint-Germain-En-Laye, 10, rue du Champs Gaillard, 78303 Poissy, France.
| | - Clotilde Poupon
- Service de chirurgie gynécologique et obstétrique de Poissy-Saint-Germain-En-Laye, 10, rue du Champs Gaillard, 78303 Poissy, France
| | - Joseph Du Cheyron
- Service de chirurgie gynécologique et obstétrique de Poissy-Saint-Germain-En-Laye, 10, rue du Champs Gaillard, 78303 Poissy, France
| | - Aygline Paternostre
- Service de chirurgie gynécologique et obstétrique de Poissy-Saint-Germain-En-Laye, 10, rue du Champs Gaillard, 78303 Poissy, France
| | - Arnaud Fauconnier
- Service de chirurgie gynécologique et obstétrique de Poissy-Saint-Germain-En-Laye, 10, rue du Champs Gaillard, 78303 Poissy, France
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Sánchez MVS, Suárez MAS, Padrón LO, Anguiano FG, Andrés EA, Barreto CM, Morales MEP, Martínez AIM. A 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Surgical Left Adnexectomy, Rectosigmoid Anastomosis, and Bilateral Ureteral Reimplantation. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e938169. [PMID: 36840346 PMCID: PMC9976473 DOI: 10.12659/ajcr.938169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Endometriosis is a chronic inflammatory disease caused by endometrial tissue that grows outside the uterus. Deep endometriosis surgery is associated with considerable rates of complications, although such rates are lower in surgical procedures carried out by expert surgical teams. This report details a case of a rare but life-threatening complication in the postoperative period following 72 h of endometriosis surgery: a giant subcapsular hepatic hematoma, which was successfully managed conservatively. CASE REPORT Here we describe the case of a 39-year-old woman with deep endometriosis with ureteral, ovarian, and intestinal involvement requiring multidisciplinary surgery. She presented with severe anemia, respiratory distress, and oliguria 72 h postoperatively. A 3-phase computed tomography (CT) scan revealed a giant intrahepatic subcapsular hematoma (180×165×50 mm) lateral to the right hepatic lobe, which was managed conservatively. The patient evolved favorably and the hematoma was reduced (77×16 mm) in a follow-up CT scan performed 5 months later. CONCLUSIONS Giant liver hematoma is a rare, life-threatening complication. The current experience relating to its management remains largely limited owing to the rarity of the condition and paucity of published cases. Actually, we found no articles on hepatic hematoma in the context of endometriosis surgery. Early diagnosis and treatment are essential to reduce the patient's risk of death. Imaging diagnosis plays an essential role.
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Affiliation(s)
- María Victoria Sánchez Sánchez
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - María Alejandra Santana Suárez
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain,Corresponding Author: María Alejandra Santana Suárez, e-mail:
| | - Ludmila Ocón Padrón
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - Fidel García Anguiano
- General and Digestive Surgery Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - Elia Archilla Andrés
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - Claudia Martínez Barreto
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - María Elena Pérez Morales
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
| | - Alicia Inmaculada Martín Martínez
- Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain
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She YM, Ge N. Diagnostic value of endoscopic ultrasonography in pelvic masses with bowel involvement. Therap Adv Gastroenterol 2023; 16:17562848231163414. [PMID: 37153498 PMCID: PMC10161300 DOI: 10.1177/17562848231163414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/26/2023] [Indexed: 05/09/2023] Open
Abstract
Benign and malignant pelvic masses with or without intestinal invasion are common in women of childbearing age. Patients may have nonspecific symptoms and signs or experience no symptoms. Laparoscopic resection of pelvic masses is currently the mainstream treatment; therefore, accurate preoperative evaluation is not only essential for patients suspected of having intestinal invasion, but also extremely important for the selection of follow-up treatment. Procedures, including endoscopic ultrasonography (EUS), pelvic magnetic resonance imaging, abdominal computed tomography, vaginal ultrasonography, barium enema, and colonoscopy, aid in determining the presence, depth, and histology of the disease. In particular, the wide application and continuous developments in EUS techniques have improved the diagnostic accuracy for intestinal subepithelial and peripheral organ lesions. This article reviewed the clinical value of EUS in the diagnosis of benign and malignant pelvic masses with bowel involvement.
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Affiliation(s)
- Yu Mo She
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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Buffeteau A, Weyl A, Vavasseur A, Meilleroux J, Pointreau A, Griffier R, Chantalat E, Vidal F. MRI and rectal endoscopy sonography performance to diagnose the digestive depth infiltration of pelvic endometriosis. Arch Gynecol Obstet 2023; 307:51-58. [PMID: 35435484 DOI: 10.1007/s00404-022-06532-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The main objective of this study was to evaluate the performances of MRI and rectal endoscopy sonography (RES) in predicting the depth of bowel wall infiltration by deep infiltrating endometriosis (DIE). MATERIAL AND METHOD We conducted a single center retrospective study from April 2014 to March 2020 including all patients who had undergone digestive tract resection (discoid or segmental) for DIE removal and who had benefited from full preoperative imaging workup based on both pelvic MRI and RES. RESULTS Fifty two patients were enrolled in the study. Median age was 35.8 years (26.1-44.5 years). Indications for surgery mainly comprised chronic pelvic pain (94.2%) and infertility (36.5%). Overall, pathological examination showed digestive involvement in 92.3% of patients, while transmural infiltration was found in 38.4% of cases. In contrast, both MRI and RES suspected transmural involvement in 42 patients (80.8%). Corresponding sensitivity and specificity were 0.95 [95% CI (0.751-0.999)] and 0.28 [95% CI (0.137-0.467)], respectively. Our results revealed agreement between MRI and RES in 85% of cases with a kappa at 0.5 [95% CI (0.207-0.803), moderate agreement]. Subgroup analysis in patients with transmural MRI lesions showed a sensitivity of 0.95 [95% CI (0.740-0.999)] and a specificity of 0.13 [95% CI (0.028-0.336)]. CONCLUSION Our study suggests that performing a second-line examination is not useful if there is no transmural impairment in MRI or RES. Nevertheless, the combination of these two preoperative examinations seems to be essential for the evaluation of the depth of digestive involvement of endometriosis to guide surgical management as effectively as possible. The constitution and training of multidisciplinary expert groups must be developed to be able to offer optimal patient management.
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Affiliation(s)
- Aurélie Buffeteau
- CHU de Toulouse, Pôle Femme Mère Couple, Hôpital Rangueil, 31059, Toulouse, France. .,CHU de Toulouse, Pôle Femme Mère Couple, Hôpital Paule de Viguier, 31059, Toulouse, France.
| | - Ariane Weyl
- CHU de Toulouse, Pôle Femme Mère Couple, Hôpital Rangueil, 31059, Toulouse, France
| | - Adrien Vavasseur
- Toulouse University Hospital, Imaging Unit, Rangueil Hospital, 31059, Toulouse, France
| | - Julie Meilleroux
- Toulouse University Hospital, Anatomopathology Unit, Purpan Hospital, 31059, Toulouse, France
| | - Adeline Pointreau
- Gastroenterology Department, Clinique de La Croix du Sud, 31130, Quint-Fonsegrives, France
| | - Romain Griffier
- Bordeaux University Hospital, Public Health Unit, Pellegrin Hospital, 33000, Bordeaux, France
| | - Elodie Chantalat
- CHU de Toulouse, Pôle Femme Mère Couple, Hôpital Rangueil, 31059, Toulouse, France.,University of Toulouse III, IRIT, CNRS, UMR 5505, Toulouse, France
| | - Fabien Vidal
- CHU de Toulouse, Pôle Femme Mère Couple, Hôpital Paule de Viguier, 31059, Toulouse, France.,University of Toulouse III, IRIT, CNRS, UMR 5505, Toulouse, France
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Advances in Imaging for Assessing Pelvic Endometriosis. Diagnostics (Basel) 2022; 12:diagnostics12122960. [PMID: 36552967 PMCID: PMC9777476 DOI: 10.3390/diagnostics12122960] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
In recent years, due to the development of standardized diagnostic protocols associated with an improvement in the associated technology, the diagnosis of pelvic endometriosis using imaging is becoming a reality. In particular, transvaginal ultrasound and magnetic resonance are today the two imaging techniques that can accurately identify the majority of the phenotypes of endometriosis. This review focuses not only on these most common imaging modalities but also on some additional radiological techniques that were proposed for rectosigmoid colon endometriosis, such as double-contrast barium enema, rectal endoscopic ultrasonography, multidetector computed tomography enema, computed tomography colonography and positron emission tomography-computed tomography with 16α-[18F]fluoro-17β-estradiol.
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Sloss S, Mooney S, Ellett L, Readman E, Ma T, Brouwer R, Yang N, Ireland-Jenkin K, Stone K, Maher P. Preoperative Imaging in Patients with Deep Infiltrating Endometriosis (DIE): An Important aid in Predicting Depth of Infiltration in Rectosigmoid Disease. J Minim Invasive Gynecol 2022; 29:633-640. [PMID: 34990811 DOI: 10.1016/j.jmig.2021.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To determine the diagnostic accuracy of specialist transvaginal ultrasound (TVUS) and pelvic magnetic resonance imaging (MRI) modalities in predicting depth of deep infiltrating endometriosis (DIE) of the rectosigmoid by comparison with histological specimens obtained at surgery. DESIGN A retrospective analysis, which met the STARD (2015) guidelines for a diagnostic accuracy study. SETTING Tertiary teaching hospital. PATIENTS 194 cases who underwent preoperative discussion at the Gynaecological Endosurgery Unit multidisciplinary meeting (MDM) between January 2012 and December 2019 were eligible for inclusion. INTERVENTIONS Retrospective assessment of the accuracy of TVUS and MRI in predicting histological depth of rectosigmoid DIE following operative management. MEASUREMENTS AND MAIN RESULTS 135 surgeries were performed for DIE; 20 underwent a rectal shave, 14 had a disc/wedge resection, 38 an anterior/segmental resection, 63 had no rectosigmoid surgery. Of the 52 patients with full thickness rectal wall excision, all patients had at least one imaging modality available for review; 42 (81%) had both. At least one imaging modality was in agreement with histological depth in 48 (92%) cases (sensitivity 94%, specificity 50%, positive predictive values (PPV) 97.9%, negative predictive value (NPV) 25.0%; area under the receiver operating curves (AUROC) 0.720, 95%CI: 0.229, 1.000). When TVUS was assessed in isolation, the test remained sensitive for any rectal wall involvement (sensitivity 93.6%, specificity 50.0%, PPV 97.8%, NPV 25.0%; AUROC 0.718, 95%CI: 0.227, 1.000). When only MRI was assessed, the test demonstrated both high sensitivity and specificity for rectal wall disease (sensitivity 86.4%, specificity 100%, PPV 100%, NPV 14.2). CONCLUSION Specialised performed TVUS and MRI are accurate in predicting depth of disease in rectosigmoid endometriosis. These modalities were similar in their diagnostic performance at assessing depth of rectal wall involvement and their use is justified in the preoperative planning of these gynaecological surgeries.
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Affiliation(s)
- Samantha Sloss
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher).
| | - Samantha Mooney
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher)
| | - Lenore Ellett
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher)
| | - Emma Readman
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher)
| | - Tony Ma
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher)
| | | | | | - Kerryn Ireland-Jenkin
- Department of Anatomical Pathology (A/Prof Ireland-Jenkin) Austin Hospital, Heidelberg, Australia
| | - Kate Stone
- Department of Medical Imaging (Dr Stone), Mercy Hospital for Women, Heidelberg, Australia
| | - Peter Maher
- Department of Gynaecology (Drs. Sloss, Mooney, Ellett, Readman, and Ma and Prof Maher)
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Popoutchi P, Marques Junior OW, Averbach P, Cardoso Filho CAM, Averbach M. SURGICAL TECHNIQUES FOR THE TREATMENT OF RECTAL ENDOMETRIOSIS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS AND OBSERVATIONAL STUDIES. ARQUIVOS DE GASTROENTEROLOGIA 2021; 58:548-559. [PMID: 34909864 DOI: 10.1590/s0004-2803.202100000-97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Endometriosis is a common disease in reproductive-age women and it is estimated to occur in up to 50% of those with infertility. Intestinal involvement is reported in up to a third of the cases. This condition is related to chronic pain and loss of quality of life, resulting in emotional, social and economic costs. Treatment consists of hormonal block and surgical resection, with variable side effects and efficacy. The best choice for surgical treatment for rectal endometriosis is a matter of discussion regarding the indication and the best technique to be employed. OBJECTIVE To summarize data on indications, results and complications of surgical techniques for the treatment of rectal endometriosis. METHODS This comprehensive systematic review is a compilation of the available literature and discussion, carried out by a team with experience in the surgical treatment of intestinal endometriosis. Data regarding indications, results and complications of conservative and radical techniques for the surgical treatment of rectal endometriosis was carefully reviewed. Searches of PubMed, EMBASE, and CENTRAL up to May 2021 were performed to identify randomized controlled trials (RCTs) and observational studies that compared at least two of the three surgical techniques of interest (i.e., shaving, discoid resection, segmental resection). RESULTS One RCT and nine case series studies with a total of 3,327 patients met the eligibility criteria. Participants ages ranged from a mean of 30.0 to 37.9 years old. Mean follow-up ranged from 1.2 to 42.76 months. With regards the methodological quality, overall the included studies presented a low risk of bias in the majority of the domains. Surgical treatment of rectal endometriosis is indicated for patients with obstructive symptoms and those with pain scores above 7/10. Patients with disease involving beyond muscularis propria of the rectum, documented in magnetic resonance imaging or transvaginal pelvic ultrasound with intestinal preparation, are candidates for discoid or segmental resection. The presence of multifocal disease, extension greater than 3 cm and infiltration greater than 50% of the loop circumference favor the radical technique. The distance from the lesion to the anal verge, age, symptoms and reproductive desire are other factors that influence the choice of the technique to be employed. The risk of complications and unfavorable functional results seems to be directly related to the complexity of the procedure. CONCLUSION The choice of surgical technique performed for the treatment of rectal endometriosis is a matter of discussion and depends not only on the preoperative staging, but also on the patient's expectations, risks and potential complications, recurrence rates and the expertise of the multidisciplinary team.
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Affiliation(s)
- Pedro Popoutchi
- Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, São Paulo, SP, Brasil
| | - Oswaldo Wiliam Marques Junior
- Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, São Paulo, SP, Brasil.,Fundação Antônio Prudente - A.C.Camargo Hospital, São Paulo, SP, Brasil
| | - Pedro Averbach
- Disciplina de Coloproctologia, Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Celso Augusto Milani Cardoso Filho
- Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, São Paulo, SP, Brasil.,Fundação Antônio Prudente - A.C.Camargo Hospital, São Paulo, SP, Brasil
| | - Marcelo Averbach
- Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, São Paulo, SP, Brasil
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Lin XL, Zhang DS, Ju ZY, Li XM, Zhang YZ. Diagnostic value of different color ultrasound diagnostic method in endometrial lesions. World J Clin Cases 2021; 9:5037-5045. [PMID: 34307554 PMCID: PMC8283585 DOI: 10.12998/wjcc.v9.i19.5037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/28/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids. Among them, endometrial cancer as a malignant tumor seriously endangers the life and health of patients. Ultrasonography is an important means of diagnosing female reproductive system diseases, and it is of critical value for the early diagnosis of endometrial cancer. However, different ultrasound inspection programs have achieved different results. It is of great significance to choose a suitable inspection program.
AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.
METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects. All patients underwent transvaginal color ultrasound and transabdominal color ultrasound. We compared the diagnostic coincidence and image display effects of the two different examination methods, and the endometrial thickness, blood flow, uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.
RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound (P = 0.001, 0.005, 0.001 and 0.001). In addition, the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound (P = 0.001). There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination (P = 0.001). The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions (P = 0.001), and the rate of the blood flow was the highest (P = 0.001). The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest, which shows that the difference was statistically significant (P = 0.001).
CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound, which held higher diagnostic coincidence rate and image display effect. There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.
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Affiliation(s)
- Xiao-Lin Lin
- Department of Ultrasound, Pingyi County Traditional Chinese Medicine Hospital, Linyi 273300, Shandong Province, China
| | - Dong-Sheng Zhang
- Department of Ultrasound, Pingyi County Traditional Chinese Medicine Hospital, Linyi 273300, Shandong Province, China
| | - Zhi-Ye Ju
- Department of Ultrasound, Rizhao Peoples Hospital, Rizhao 276800, Shandong Province, China
| | - Xiu-Ming Li
- Department of Gastroenterology, Pingyi County Traditional Chinese Medicine Hospital, Linyi 273300, Shandong Province, China
| | - Yao-Zhu Zhang
- Department of Ultrasound, Rizhao Peoples Hospital, Rizhao 276800, Shandong Province, China
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10
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Biscaldi E, Barra F, Leone Roberti Maggiore U, Ferrero S. Other imaging techniques: Double-contrast barium enema, endoscopic ultrasonography, multidetector CT enema, and computed tomography colonoscopy. Best Pract Res Clin Obstet Gynaecol 2020; 71:64-77. [PMID: 32698994 DOI: 10.1016/j.bpobgyn.2020.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 02/07/2023]
Abstract
Double-contrast barium enema (DCBE), transrectal endoscopic ultrasonography (REU), multidetector computerized tomography enema (MDCT-e), and computed tomography colonoscopy (CTC) have been successfully used for the diagnosis of bowel endometriosis. DCBE provides a complete overview of the entire colon and allows detecting cecal nodules. The accuracy of DCBE is operator dependent and, thus, it may have low specificity. It does not allow identifying the cause of the mass effect. DCBE requires the administration of barium and exposure to radiation. REU precisely estimates the distance between the rectosigmoid nodule and the anal verge. However, it allows investigating only the distal part of rectosigmoid, it misses anterior pelvic lesions, and it has poor sensitivity for the diagnosis of endometriomas. MDCT-e is accurate and reproducible in diagnosing intestinal endometriosis and in assessing its characteristics: the largest diameter of the nodule, the distance between the distal part of the nodule and the anal verge, and depth of infiltration of endometriosis in the intestinal wall. MDCT-e requires the administration of iodinated contrast medium (CM) and the exposure to radiations. CTC has good performance in the diagnosis of rectosigmoid endometriosis. It allows estimating the degree of intestinal stenosis CTC, and the distance between the intestinal endometriotic nodule and the anal verge. It requires exposure to radiations, and it may require the administration of an iodinated CM.
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Affiliation(s)
- Ennio Biscaldi
- Department of Radiology, Galliera Hospital, via Mura delle Cappuccine 14, Genova, 16128, Italy
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
| | | | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy
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