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Endometriosis

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Coloproctology

Part of the book series: European Manual of Medicine ((EUROMANUAL))

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Abstract

Endometriosis is the presence of endometrial-like tissue outside the uterus. It is common affecting 6–10 % of women during childbearing years and is recognized as a condition with significant social impact as related symptoms may heavily impact on patient quality of life. The digestive tract is involved in approximately one quarter of cases.

The diagnosis is suggested by the history, symptoms and physical signs and is supported by physical examination and imaging techniques (transvaginal and endorectal ultrasound, magnetic resonance and CT scan). Confirmation of the diagnosis relies on histological examination of specimens collected at time of surgery.

The etiology of endometriosis is unknown therefore treatment is not directed at a cure but at reducing related symptoms and improving quality of life. Medical treatment should be considered initially and bowel surgery should be reserved for intractable symptoms. Surgery is often very challenging because the infiltration of various structures by endometriotic nodules. The potential advantages of surgery have to be balanced with the risk of complications. Surgical treatment needs a multidisciplinary approach and a surgical team well-trained in pelvic and laparoscopic surgery. A laparoscopic approach is preferable. No clear guidelines exist concerning the relative advantages of peeling, disk or segmental resection in the treatment of intestinal nodules. Complete resection of deep infiltrative endometriosis with a low complication rate is likely to result in significant symptom improvement and quality of life in usually young patients. Therefore such surgery has to be performed in referral centres.

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Authors and Affiliations

  1. Department of Surgery, Galliera Hospital, via Mura delle Capuccine 14, Genoa, 16128, Italy

    Gian Andrea Binda M.D. & Alberto Serventi M.D.

  2. Department of Gynecology, Galliera Hospital, Mura delle Cappuccine, 14, Genoa, 16128, Italy

    Alessandro Fasciani M.D.

Authors
  1. Gian Andrea Binda M.D.
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  2. Alberto Serventi M.D.
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  3. Alessandro Fasciani M.D.
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Correspondence to Gian Andrea Binda M.D. .

Editor information

Editors and Affiliations

  1. End- und Dickdarm-Zentrum Mannheim, Mannheim, Germany

    Alexander Herold

  2. Clinique de chirurgie digestive et endocrinienne, Institut des maladies de l’appareil digestif, Hotel Dieu, Nantes, France

    Paul-Antoine Lehur

  3. Chirurgische Klinik mit Poliklinik, Universitaet Erlangen, Erlangen, Germany

    Klaus E. Matzel

  4. UCD School of Medicine, St Vincent’s University Hospital, Dublin, Ireland

    P. Ronan O'Connell

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Binda, G.A., Serventi, A., Fasciani, A. (2017). Endometriosis. In: Herold, A., Lehur, PA., Matzel, K., O'Connell, P. (eds) Coloproctology. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53210-2_20

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  • DOI: https://doi.org/10.1007/978-3-662-53210-2_20

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