Derin İnfiltratif Endometriozisde Rektumun Segmental Rezeksiyonu
Synopsis
Kolorektal rezeksiyonla bağırsak derin infiltre eden endometriozis (DIE) yönetimi karmaşık bir işlemdir. DIE, alt tipler arasında en kötüsüdür çünkü çevre yapılara infiltran özellikte nodül oluşturmaktadır. Kolorektal endometriozis DIE tanısını koymak için ayrıntılı klinik öykü, fizik muayene ve görüntüleme yöntemleri gereklidir. Bağırsak tutulumlu DIE tedavisinde cerrahiye geçiş zamanı lezyonun semptomatik hale gelip tıbbi tedaviye yanıt vermediği ve yaşam kalitesinin düşük olduğu zamandır.DIE için cerrahi tedaviye lezyon boyutu, sayısı, yeri infiltrasyon derinliği ve bağırsak lümen stenozunun derecesinin değerlendirilmesinden sonra karar verilir. Kolorektal endometriozis nodülleri için kullanılan cerrahiler; radikal cerrahi veya konservatif cerrahi olarak ayrılabilir. Kolorektal endometriozis DIE segmental kolorektal rezeksiyonu ve anastomozu, multidisipliner cerrahi uzmanlığı ekibi gerektiren oldukça karmaşık bir cerrahidir.
Management of deep infiltrating endometriosis (DIE) with colorectal resection is a complex procedure. DIE is the worst of the subtypes because it forms nodules that infiltrate the surrounding structures. A detailed clinical history, physical examination, and imaging studies are required to diagnose DIE with colorectal endometriosis. The time to proceed to surgery in the treatment of DIE with bowel involvement is when the lesion becomes symptomatic, does not respond to medical treatment, and the quality of life is poor. Surgical treatment for DIE is decided after evaluating the size, number, location, depth of infiltration, and degree of bowel lumen stenosis of the lesions. Surgeries used for colorectal endometriosis nodules can be divided into radical surgery or conservative surgery. Colorectal endometriosis DIE segmental colorectal resection and anastomosis is a highly complex surgery requiring a multidisciplinary surgical expertise team.
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