PURPOSE: Surgical treatment of females with @entity46 is challenging. The aim of this study was to review the results of laparoscopic intervention in the management of females with this @entity74 . METHOD: All cases of complex tertiary @entity530 requiring laparoscopic surgical intervention of the rectum were identified and reviewed from a prospective database. RESULTS: Between April 1996 and August 2004, 95 @entity1 with @entity530 involving the rectum had laparoscopic surgical procedures performed by one gynecologist and one colorectal surgeon. Eighty percent of rectal procedures were completed laparoscopically. Forty-three (45 percent) were treated with diathermy excision, 18 (19 percent) had shave partial-thickness disc excision, 20 (21 percent) had full-thickness disc excision (including 14 endoanally using a circular stapler), while 14 (15 percent) were managed with laparoscopic-assisted segmental low anterior resection. A history of @entity158 during defecation present only during menstruation (adjusted odds ratio=8.6, 95 percent confidence interval (CI)=1.8-41.2) and previous laparoscopy (adjusted odds ratio=3.2, 95 percent CI=1.2-8.3) independently predicted a need for more extensive surgery than diathermy excision. There were no rectal anastomotic leaks, with 8 percent overall morbidity. The only significant predictor of @entity86 was a history of @entity546 (P=0.03). CONCLUSIONS: @entity1 with complex endometriosis of the rectum can be safely managed laparoscopically using a multidisciplinary approach. This case series suggests that a history of @entity158 during defecation that occurs only during menstruation is predictive of females with more extensive @entity5584 .

Laparoscopic management of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity530 :: ('MESH:D010386', 'Disease') :: ['referral pelvic endometriosis', 'pelvic endometriosis'] @entity5584 :: ('MESH:D012002', 'Disease') :: ['rectal disease'] @entity46 :: ('MESH:D004715', 'Disease') :: ['rectal endometriosis'] @entity74 :: ('MESH:D030342', 'Disease') :: ['complex disorder'] @entity158 :: ('MESH:D010146', 'Disease') :: ['rectal pain'] @entity86 :: ('MESH:D019106', 'Disease') :: ['ongoing postoperative symptoms'] @entity546 :: ('MESH:D004414', 'Disease') :: ['dyspareunia']
@entity46 :: (MESH:D004715,Disease) :: ['rectal endometriosis']
