Nirgianakis, Konstantinos; Mc Kinnon, Brett; Imboden, Sara; Knabben, Laura Michelle Tatjana; Gloor, Beat; Mueller, Michael (2014). Laparoscopic management of bowel endometriosis: resection margins as a predictor of recurrence. Acta obstetricia et gynecologica Scandinavica, 93(12), pp. 1262-1267. Wiley-Blackwell 10.1111/aogs.12490
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OBJECTIVE
To evaluate possible predictive factors for recurrence after laparoscopic segmental bowel resection for bowel endometriosis.
DESIGN
Cohort study.
SETTING
Academic tertiary referral center.
METHODS
95 symptomatic women with bowel endometriosis who underwent laparoscopic segmental bowel resection at the Endometriosis clinic, University of Berne, between 2002 and 2012 were enrolled. Since 14 women were lost to follow-up, 81 formed the final cohort. Clinical and histological characteristics were examined as possible predictive factors for disease recurrence.
MAIN OUTCOME MEASURES
Recurrence, defined as a subsequent operation due to recurrent endometriosis-associated pain with a histologically confirmed endometriotic lesion.
RESULTS
Recurrence was observed in 13 (16%) patients. Variables that were significantly associated to recurrence by the Cox regression analysis were positive bowel resection margins (hazard ratio 6.5, 95% confidence interval 1.8-23.5, p = 0.005), age <31 years (hazard ratio 5.6, 95% confidence interval 1.7-18.6, p = 0.005) and body mass index ≥23 kg/m(2) (hazard ratio 11.0, 95% confidence interval 2.7-44.6, p = 0.001).
CONCLUSIONS
Positive bowel resection margins as well as age <31 years and body mass index ≥23 kg/m(2) appear to be independent predictors of disease recurrence.
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