Власний досвід симультанного хірургічного лікування пацієнток із глибоким інвазивним ендометріозом з ураженням ректосигмоїдного відділу товстої кишки

Abstract

Endometriosis affects approximately 10% of women globally and can lead to infertility (30-50% of cases) and a significant decline in quality of life. One of the most severe forms of this disease is deep infiltrative endometriosis (DIE). Аim - to evaluate the effectiveness of multidisciplinary surgical treatment for patients with DIE in the short term. Materials and methods. The study included 18 patients with confirmed DIE and bowel involvement, treated. Laparoscopic surgical interventions were performed following Enhanced Recovery After Surgery principles. The parameters assessed included the duration of surgery, pain level, length of hospital stay, and early postoperative complications. Results. The average duration of surgery was 145.83±15.3 minutes. Bowel involvement was localized to the anterior surface of the rectum in 7 cases and the rectosigmoid area in 4 cases. The average size of endometriotic lesions was 3.83±0.75 cm. All resections were performed with R0 margins, and no protective stoma was placed. Early postoperative complications included transient nausea and vomiting in 6 patients, managed conservatively. Pain levels, measured by the ACCS scale, were 57.51±10.51 points at 12 hours post-operation and 19.7±8.51 points after 24 hours. The average hospital stay was 3.66±0.81 days. After 3 months, 6 patients reported complete symptom relief, 6 noted significant symptom reduction, and 12 experienced improved quality of life. Conclusions. Multidisciplinary laparoscopic surgical treatment of deep infiltrative endometriosis with bowel involvement is safe and effective in the short term. Patients show significant improvement in quality of life and reduction in pain. However, long-term evaluation of the condition is necessary. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.