alexa Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management.
Surgery

Surgery

Journal of Surgery

Author(s): Abro MS, Petraglia F, Falcone T, Keckstein J, Osuga Y,

Abstract Share this page

Abstract BACKGROUND: Deep endometriosis invading the bowel constitutes a major challenge for the gynecologist. In addition to the greater impact on pain, the high incidence of surgical morbidity involved with bowel endometriosis poses a therapeutic dilemma for the surgeon. Intestinal involvement by deep endometriotic nodules has been estimated to occur in 8-12\% of women with endometriosis. Individual and clinical factors, pre-operative morphologic characteristics from imaging, surgical considerations and impact on quality of life are critical variables that should be considered in determining the best therapeutic strategy for a patient with deep endometriosis involving the sigmoid and/or the rectum. Pre-operative planning is fundamental for defining the optimal therapeutic strategy; patient counseling of treatment options, and when surgery is indicated, involvement of a multidisciplinary surgical team is required. METHODS: The PubMed and Cochrane database were searched for all original and review articles published in English, French and Italian, until June 2014. Search terms included 'deep endometriosis', 'surgical and clinical approach', 'bowel disease', 'quality of life', 'management of deep endometriosis'. Special attention was paid to articles comparing features of discoid and segmental resection. RESULTS: The rationale for the best therapeutic options for patients with deep endometriosis has been shown and an evidence-based treatment algorithm for determining when and which surgical intervention may be required is proposed. In deciding the best treatment option for patients with deep endometriosis involving the sigmoid and rectum, it is important to understand how the different clinical factors and pre-operative morphologic imaging affect the algorithm. Surgery is not indicated in all patients with deep endometriosis, but, when surgery is chosen, a complete resection by the most appropriate surgical team is required in order to achieve the best patient outcome. CONCLUSION: In women with deep endometriosis, surgery is the therapy of choice for symptomatic patients when deep lesions do not improve with a medical treatment. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: [email protected] This article was published in Hum Reprod Update and referenced in Journal of Surgery

Relevant Expert PPTs

Relevant Speaker PPTs

  • Li Yu-Jung
    Intra-maxillary Drug delivery and Bio-sensing via Dental Implant and its considerations
    PPT Version | PDF Version
  • Nicolae Bacalbasa
    The benefits of surgery for breast cancer liver metastases – a single center experience
    PPT Version | PDF Version
  • Sitanshu Sekhar Lahiri
    A novel oral formulation for cancer therapy, loaded in a slow release matrix for targeted delivery
    PPT Version | PDF Version
  • Li-Chun Tsou
    Drug delivery device strategy for patient centric therapies
    PDF Version
  • Dipesh Shah
    Compatibility assessment of a model monoclonal antibody formulation in glass and in blow-fi ll-seal (BFS) plastic vial delivery formats
    PPT Version | PDF Version
  • Stephanie Ramos
    Enhanced Delivery of Dna-Based Vaccines and Immunotherapeutics through Next-Generation Electroporation Devices
    PPT Version | PDF Version
  • Suzi Demirbag
    Indications and effectiveness of the open surgery in vesicoureteral refl ux
    PPT Version | PDF Version
  • Mehmet Ozler
    “Mehmet Ozler-Gulhane-Military-Medical-Academy-Ankara-Turkey-Pinealectomy-Initiates-the-Oxidative-Stress-Response-in-Brain-Tissue-of-Rats-Subject-to-Abdominal-Surgery”
    PPT Version | PDF Version
  • Nirmala Chauhan
    Modification of dietary fiber psyllium for use in oral insulin delivery
    PPT Version | PDF Version
  • Youngmi Jung
    TSG-6 induces liver regeneration by enhancing autophagy in mice with chronic liver damage
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Suoqin Tang
    Survivin siRNA nano particles are capable of inhibiting liver cancer cell growth both in vitro and in vivo
    PPT Version | PDF Version
  • Arshad mahmood
    TRANSPORT OF SELF-NANOEMULSIFYING DRUG DELIVERY SYSTEM (SNEDDS) ACROSS MUCUS AND CELLULAR INTERNALIZATION
    PPT Version | PDF Version
  • Wei Duan
    Cancer stem cells targeted delivery of siRNA to overcome induced chemoresistance
    PPT Version | PDF Version
  • Yung-Chih Kuo
    “Yung-Chih Kuo-National-Chung-Cheng-University-Republic-of-China-Targeting-delivery-of-etoposide-to-inhibit-the-growth-of-human-glioblastoma-multiforme-using-lactoferrin-and-folic-acid-grafted-poly(lactide-co-glycolide)-nanoparticles”
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords