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Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis
D B Redwine1, M Koning, D R Sharpe
1St. Charles Medical Center, Bend, Oregon, USA.
Objective:
To compare three methods of segmental lower colon resection for treatment of symptomatic intestinal endometriosis.
Design:
Retrospective case study.
Setting:
Private practice patients in a rural community hospital.
Patients:
Patients with nodular, invasive rectosigmoid endometriosis requiring segmental resection and anastomosis for treatment. Laparotomy patients were matched with laparoscopy patients for severity of intestinal endometriosis.
Interventions:
Segmental resection of the rectosigmoid colon by laparotomy, by a laparoscopic Intracorporeal technique or by a laparoscopically assisted transvaginal technique.
Main Outcome Measures:
Length of surgery, length of hospital stay, operating room charges and total hospital charges corrected to 1995 dollars.
Results:
Compared with laparotomy segmental colon resection for endometriosis, laparoscopic transvaginal segmental resection resulted in a shorter length of stay, equivalent operating room charges, and significantly lower total hospital charges. The laparoscopic transvaginal technique is much faster, safer, and less fatiguing to the surgeon than a total intracorporeal technique.
Conclusions:
Laparoscopically assisted transvaginal segmental rectosigmoid resection for endometriosis is a promising technique that is simpler than a laparoscopic intracorporeal segmental resection technique and is less costly than a laparotomy segmental resection technique.