7360 Surgical Management of Ileocecal Endometriosis, 6 Cases Treated with Laparoscopic Ileocecal Resection

Study Objective To present and discuss clinical features of ileocecal endometriosis (ICE) and feasibility of laparoscopic surgery for ICE. Design Retrospective cohort study. Setting Gynecology and Obstetrics department of a general hospital. Patients or Participants All patients who underwent laparoscopic surgery for ICE. Interventions Between December 2010 and January 2021, 6 patients underwent laparoscopic ileocecal resection for ICE. Measurements and Main Results A total of 6 patients (median age 37.0) underwent laparoscopic ileocecal resection. Five of the six cases had preoperative symptoms from ileocecal lesions such as bowel obstruction and abdominal pain. Three cases were diagnosed with ileal stenosis by contrast X-ray with nasointestinal tubes, and the other three were diagnosed with ICE by colonoscopy or double contrast barium enema (DCBE). All 6 patients had concomitant rectal endometriosis and underwent simultaneous laparoscopic lower anterior resection. In one case, ureteral stent placement was required for ureteral injury, and in one case, intestinal obstruction occurred postoperatively, but both cases improved without sequel. Postoperative hormone therapy with dienogest was performed in five patients. One patient underwent bilateral adnexectomy. No recurrence was observed in all patients (the median observation time: 48 month). Conclusion All patients with ileocecal endometriosis had rectal endometriosis and required two segmental intestinal resections. Laparoscopic surgery for ICE needs deep understanding of the gastrointestinal tract and advanced techniques of laparoscopic surgery, as well as cooperation with surgeons.