Computed tomography-based virtual colonoscopy in the assessment of bowel endometriosis: The surgeon's point of view

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• 作者：H. Roman^a ; ^b ; ^{horace.roman@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; J. Carilho^a ; C. Da Costa^c ; C. De Vecchi^c ; O. Suaud^d ; M. Monroc^e ; P. Hochain^e ; M. Vassilieff^a ; C. Savoye-Collet^c ; M. Saint-Ghislain^a
• 关键词：Computed tomography-based virtual colonoscopy ; Endorectal ultrasound ; Colorectal endometriosis ; Bowel endometriosis
• 刊名：Gynecology Obstetrique & Fertilite
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：44
• 期：1
• 页码：3-10
• 全文大小：2683 K

文摘

To discuss the role of computed tomography-based virtual colonoscopy (CTC) in preoperative assessment of bowel endometriosis.

Methods

Retrospective study using data prospectively recorded, including 127 patients with colorectal endometriosis, having undergone CTC for bowel endometriosis. The study was conducted in a tertiary referral center during 38 consecutive months. Preoperative assessment included CTC, magnetic resonance imaging (MRI), endorectal ultrasound (ERUS) and clinical examination. Information concerning identification of deep infiltrating endometriosis (DIE) of the bowel, the length and height of colorectal involvement, stenosis of digestive lumen and associated digestive localizations were compared with intraoperative findings.

Results

Sensitivity and specificity of CTC for DIE of the rectum, the sigmoid colon, associated digestive localizations, and stenosis of the digestive lumen were respectively 97% and 84%, 93% and 88%, 84% and 97%, 96% and 96%. Intraoperative estimation of the length of digestive tract involved by DIE was closer to that provided by CTC than those provided by MRI and ERUS. When CTC revealed stenosis of digestive lumen, higher rates of colorectal resection (63% vs. 9.6%, < 0.001) and disc excision (25.9% vs. 11%, 0.03) were recorded.

Discussion

For those surgeons using various procedures for management of bowel endometriosis, accurate information on the length and height of bowel involvement, as well as the existence of bowel stenosis enables informed decision regarding the feasibility of conservative techniques versus bowel resection. Preoperative identification of associated localizations above the sigmoid colon is another major advantage related to CTC.

Conclusions

CTC provides accurate data on the length and height of colorectal involvement by DIE, stenosis of digestive lumen and associated lesions of digestive tract, which impact on the choice of surgical procedure.