- 作者：Makoto Jinushi ; Atsushi Arakawa ; Toshiharu Matsumoto ; Jun Kumakiri ; Mari Kitade ; Iwaho Kikuchi ; Kazuhiro Sakamoto ; Satoru Takeda
- 关键词：Endometriotic foci ; Histopathology ; Infiltration ; Intestinal endometriosis ; Laparoscopy ; Low anterior resection ; Satellite lesion
- 刊名：Journal of Minimally Invasive Gynecology
- 出版年：2011
- 出版时间：January-February 2011
- 年：2011
- 卷：18
- 期：1
- 页码：48-53
- 全文大小：944 K
Study ObjectiveTo determine how intestinal endometriosis spreads, and, thus, to improve outcomes of curative surgery.Design
Descriptive study (Canadian Task Force classification II-2).
Setting
University hospital.
Patients
Ten patients who underwent laparoscopic low anterior resection of intestinal endometriosis at our hospital between January 1999 and August 2007.
Intervention
Laparoscopic low anterior resection of intestinal endometriosis.
Measurements and Main Results
Mapping of endometriotic foci, degree of vertical infiltration to the intestinal layers, and longitudinal spread of endometriotic foci to the intestinal plane were defined using hematoxylin-eosin, estrogen receptor, progesterone receptor, and CD10 staining.
Results
Endometriotic foci tended to spread concentrically around a primary lesion that comprised most of a resected specimen. The deepest layer containing endometriotic foci at the primary lesion was the submucosal layer in 7 specimens (70 % ), and the internal circular muscle layer in 3 (30 % ). Satellite lesions comprising thickened areas that were independent of the primary lesion were detected in 5 specimens (50 % ). Multiple endometriotic foci were confirmed in all satellite lesions.
Conclusions
Endometriotic foci might not only infiltrate the primary lesion in intestinal endometriosis but also disseminate to other areas. Thus, the primary lesion of intestinal endometriosis with a large margin must be excised via low anterior resection.