Abstract
Background
The objective of this study was to evaluate the feasibility and safety of a more versatile rectosigmoid nodulectomy technique using a linear stapler.
Methods
Case series. Setting: tertiary care (reference center for endometriosis surgery). Patients: Sixty-one consecutive patients who were operated on between January 2006 and February 2013. Intervention: anterior rectal wall nodulectomy technique using sequential bites of the linear stapler. Measurements: Perioperative complications were recorded, and a condition-specific bowel dysfunction quality of life questionnaire (Rome III—Constipation) was applied pre-operatively and post-operatively during the first week of April 2013. Design classification: Canadian Task Force III
Results
A total of 61 patients were submitted to the intervention. After a mean follow-up period of 1.83 years (.25–7.1 ± 1.97), no post-operative fistula or leakage was observed. In addition, no cases of rectal stenosis or bowel obstruction were recorded, and two patients were excluded for not answering the post-operative questionnaire. According to the Rome III questionnaire, constipation symptoms improved significantly in 12 out of 17 questions. No patient reported worsening of symptoms in question.
Conclusions
Linear stapler resection is a safe alternative to segmentar resection for endometriotic nodules on the anterior rectal wall.
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Acknowledgements
Authors would like to thank T. C. S. Bonetti, Ph.D. for her assistance in statistical analysis and to J. Ottolia M.D. for her assistance in the application of Rome III questionnaire.
Disclosures
Drs. Gil Kamergorodsky, Nucelio Lemos, Francisco C. Rodrigues, Fernando Yassuo Asanuma, Paulo D’Amora, Eduardo Schor, and Manoel J. B. C. Girão have no conflicts of interest or financial ties to disclose.
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Kamergorodsky, G., Lemos, N., Rodrigues, F.C. et al. Evaluation of pre- and post-operative symptoms in patients submitted to linear stapler nodulectomy due to anterior rectal wall endometriosis. Surg Endosc 29, 2389–2393 (2015). https://doi.org/10.1007/s00464-014-3945-4
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DOI: https://doi.org/10.1007/s00464-014-3945-4