Abstract
Purpose
To evaluate the changes in quality of life (QOL) over a 1-year follow-up period in patients submitted to laparoscopic colorectal resection for the treatment of deep endometriosis.
Methods
A prospective observational cohort study (Canadian Task Force Design Classification II) involving 40 women with intestinal deep endometriosis was conducted between June 2007 and September 2008 at the Department of Obstetrics and Gynecology, Santa Casa Medical School, Sao Paulo, Brazil. Prior to the surgical procedure, all patients received magnetic resonance studies of the pelvis and rectal echoendoscopy, which suggested intestinal involvement of the disease in all cases. The patients received laparoscopic colorectal resections and treatment for other endometriotic lesions. The subjects completed the QOL SF-36 at 3 time points (T0 pre-operatively; T1 6 months post-operatively; and T2 1 year post-operatively).
Results
The physical functioning, role physical, social functioning and role emotional subscales evidenced the most substantial median increases for T0, T1 and T2. The pain, general health, vitality and mental health domains showed slight changes and increases in medians but did not increase to the same extent as the previous group. Significant improvements were observed in all domains of the SF-36 throughout the study period (p < 0.05). Physical health-related QOL domains showed greater improvement than mental health domains. Analyses of age, parity and body mass index as potential factors influencing the impact of surgery on QOL revealed no differences. Therefore, these factors were not used as prognostic indicators for the surgical procedure or for patient follow-up. In addition, we noted that the patients with poorest results on the initial QOL questionnaire showed the greatest improvements at the end point.
Conclusion
The study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.
References
Chapron, C., Liaras, E., Fayet, P., Hoeffel, C., Fauconnier, A., Vieira, M., et al. (2003). Anatomical distribution of deeply infiltrating endometriosis: Surgical implications and proposition for a classification. Human Reproduction, 18, 157–163.
Dubernard, G., Piketty, M., Rouzier, R., Houry, S., Bazot, M., & Darai, E. (2006). Quality of life after laparoscopic colorectal resection for endometriosis. Human Reproduction, 21(5), 1243–1247.
Angioni, S., Periretti, M., Zirone, M., Palomba, M., Mais, V., Gome, V., et al. (2006). Laparoscopic excision of posterior vaginal fornix in the treatment of patients with deep endometriosis without rectum involvement: Surgical treatment and long-term follow up. Human Reproduction, 21(6), 1629–1634.
Busacca, M., Chiaffarino, F., Candiani, M., Vignali, M., Bertulessi, C., Oggioni, G., et al. (2006). Determinants of long-term clinically detected recurrence rates of deep, ovarian, and pelvic endometriosis. American Journal of Obstetrics and Gynecology, 195(2), 423–426.
Dubernard, G., Rouzier, R., et al. (2008). Urinary complications after surgery for posterior deep infiltration endometriosis are related to the extent of dissection and to uterosacral ligaments resection. Journal of Minimally Invasive Gynecology, 15(2), 235–240.
Garry, R., Clayton, R., et al. (2000). The effect of endometriosis and its radical laparoscopic excision on quality of life indicators. BJOG, 107(1), 44–54.
Anaf, V., Simon, P., et al. (2001). Impact of surgical resection of rectovaginal pouch of douglas endometriótico nodules on pelvic pain and some elements of patients sex life. The Journal of the American Association of Gynecologic Laparoscopists, 8(1), 55–60.
Remorgida, V., Ferrero, S., et al. (2007). Bowel endometriosis: Presentation, diagnosis and treatment. Obstetrical and Gynecological Survey, 62(7), 461–470.
Bergqvist, A., & Teorell, T. (2001). Changes in quality of life after hormonal treatment of endometriosis. Acta Obstetricia et Gynecologica Scandinavica, 80(7), 628–637.
Jones, G., Kennedy, H. S., et al. (2006). Measuring quality of life in women with endometriosis: Tests of data quality, score reliability, response rate and scaling assumptions of the endometriosis health profile questionnaire. Human Reproduction, 21(10), 2686–2693.
Thomassin, I., Bazot, M., et al. (2004). Symptoms before and after surgical removal of colorectal endometriosis that are assessed by magnetic resonance imaging and rectal endoscopic sonography. American Journal of Obstetrics and Gynecology, 190(5), 1264–1271.
Emmanuel, K., & Davis, C. (2005). Outcomes and treatment options in rectovaginal endometriosis. Current Opinion in Obstetrics and Gynecology, 17(4), 399–402.
Ribeiro, P. A. A. G., Rodrigues, F. C., et al. (2006). Laparoscopic resection of intestinal endometriosis: A 5 year experience. Journal of minimally invasive gynecology, 13, 442–446.
Ciconelli, R. M., Ferraz, M. B., Santos, W., Meinão, I., & Quaresma, (1999). Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Revista brasileira de reumatologia, 39, 143–150.
Abdalla-Ribeiro, H., Ribeiro, P. A., et al. (2008). Double-contrast barium enema and transrectal endoscopic ultrasonography in the diagnosis of intestinal deeply infiltrating endometriosis. Journal of minimally invasive gynecology, 15, 315–320.
Darai, E., Thomassin, I., et al. (2005). Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis. American Journal of Obstetrics and Gynecology, 192, 394–400.
Marpeau, O., Thomassin, I., et al. (2004). Laparoscopic colorectal resection for endometriosis: Preliminary results. Journal de gynécologie, obstétrique et biologie de la reproduction, 33(7), 600–606.
Darai, E., Bazot, M., et al. (2007). Outcome of laparoscopic colorectal resection for endometriosis. Current Opinion in Obstetrics and Gynecology, 19(4), 308–313.
Darai, E., Coutant, C., et al. (2009). Relevance of quality of life questionnaires in women with endometriosis. Gynécologie, obstétrique & fertilité, 37(3), 240–245.
Dubernard, G., Rouzier, R., et al. (2008). Use of the SF-36 questionnaire to predict quality of improvement after laparoscopic colorectal resection for endometriosis. Human Reproduction, 23(4), 846–851.
Bassi, M. A., Podgaec, S., et al. (2011). Quality of life after segmental resection of the rectosigmoid by laparoscopy in patients with deep infiltrating endometriosis with bowel involvement. Journal of minimally invasive gynecology, 18(6), 730–733.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is a Master’s Thesis for Vanessa Gozzo Sekula.
Rights and permissions
About this article
Cite this article
Ribeiro, P.A.A., Sekula, V.G., Abdalla-Ribeiro, H.S. et al. Impact of laparoscopic colorectal segment resection on quality of life in women with deep endometriosis: one year follow-up. Qual Life Res 23, 639–643 (2014). https://doi.org/10.1007/s11136-013-0481-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-013-0481-y