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Master Thesis

Comparaison des résections colorectales segmentaire et discoïde par cœlioscopie pour endométriose digestive

Abstract : Background: laparoscopically assisted segmental colorectal resection is a validated technique for bowel endometriosis, one of the most severe forms of endometriosis. However, a concept of conservative colorectal surgery, based on rectal shaving or discoid resection, could have many potential benefits. Objective: the objective was to compare the clinical outcomes of segmental and discoid resection in patients withcolorectal endometriosis using propensity score matching (PSM) analysis. Study design. We conducted a retrospective study comparing 31 patients who underwent discoid colorectal resection with 31 patients with segmental colorectal resection by PSM analysis. The median follow-­-up was 247 days (8.2 months). The primary endpoint was intra and postoperative complications, and the secondary the occurrence of voiding dysfunction. Results: discoid colorectal resection was associated with a shorter operating time (155 vs 180 min, p=0.03) and hospital stay (7 vs 8 days, p=0.002) than segmental colorectal resection but a similar intra-­- and postoperative complication rate. A higher rate of postoperative voiding dysfunction was observed in the segmental resection group (19% vs 45%, p=0.03), as well as duration of voiding dysfunction requiring bladder self-catheterization longer than 30 days (0 vs 22%, p=0.005). We did not demonstrate any difference in post-operative, digestive, urinary or sexual quality oflife or difference in satisfaction between the two surgical techniques. Conclusion: our PSM analysis brings further evidence of the advantages of discoid resection as it results in a similar surgical complication rate to segmental resection but with shorter operating time, hospital stay and lower rate of voiding dysfunction.
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Master Thesis
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Aude Jayot. Comparaison des résections colorectales segmentaire et discoïde par cœlioscopie pour endométriose digestive . Médecine humaine et pathologie. 2017. ⟨dumas-01736185⟩

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