AB041. SOH24AB_105. Evaluating the use of pre-operative colonoscopy prior to combined colorectal/gynaecological surgery for stage IV endometriosis
Clinical Gastrointestinal Session

AB041. SOH24AB_105. Evaluating the use of pre-operative colonoscopy prior to combined colorectal/gynaecological surgery for stage IV endometriosis

Conor Kilkenny1, Alison DeMaio2, Aoife O’Neill2, Cillian Clancy1

1Department of Colorectal Surgery, Tallaght University Hospital, Tallaght, Dublin, Ireland; 2Department of Gynaecology, Tallaght University Hospital, Tallaght, Dublin, Ireland

Background: Less than 10% of patients with stage IV endometriosis and bowel involvement will have evidence of endometriosis intra-luminally. Colonoscopy is however still used in almost all patients pre-operatively. The purpose of this study is to correlate operative complexity and endoscopic findings in patients undergoing surgery for stage IV endometriosis in Tallaght University Hospital.

Methods: Patients undergoing combined colorectal/gynaecological surgery for stage IV endometriosis with sigmoid and rectal involvement diagnosed on magnetic resonance imaging (MRI) were recorded in a prospectively maintained database. All patients undergoing combined surgery from October 2022 to October 2023 were included. A chart and electronic records review assessed their pre-operative endoscopic findings.

Results: During the study period, 22 patients underwent combined colorectal/gynaecological surgery. The mean age was 42.7 years. Among the 22 patients, 18 (82%) underwent extensive pelvic adhesiolysis with excision of rectal deposits, while 2 (9%) required pelvic adhesiolysis with excision of deposits and stoma formation. Another 2 patients (9%) required low anterior resection with loop ileostomy formation. Pre-operative endoscopic assessment was conducted in 16 out of 22 patients (73%). Of these, 12 had no findings on colonoscopy, 4 had rectosigmoid angulation preventing scope progression. In total, 2 out of 12 patients (17%) who did not require stoma or resection had impassable angulation during endoscopy. Additionally, 2 out of 4 (50%) patients who had stoma or resection had impassable angulation (P=0.18).

Conclusions: The use of endoscopy as a pre-operative investigation in patients with stage IV endometriosis and rectal involvement remains unclear. Based on this study endoscopy could be performed on an individualised basis.

Keywords: Bowel; colonoscopy; endometriosis; laparoscopy; pre-op

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab041
Cite this abstract as: Kilkenny C, DeMaio A, O’Neill A, Clancy C. AB041. SOH24AB_105. Evaluating the use of pre-operative colonoscopy prior to combined colorectal/gynaecological surgery for stage IV endometriosis. Mesentery Peritoneum 2024;8:AB041.

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