Histopathologic Analysis of Intestinal Endometriosis after Laparoscopic Low Anterior Resection

作者：Jinushi Makoto; Arakawa Atsushi; Matsumoto Toshiharu; Kumakiri Jun^*; Kitade Mari; Kikuchi Iwaho; Sakamoto Kazuhiro; Takeda Satoru

来源：Journal of Minimally Invasive Gynecology, 2011, 18(1): 48-53.

DOI：10.1016/j.jmig.2010.08.696

• Endometriotic foci
• Histopathology
• Infiltration
• Intestinal endometriosis
• Laparoscopy
• Low anterior resection
• Satellite lesion

Study Objective: To determine how intestinal endometriosis spreads, and, thus, to improve outcomes of curative surgery.
Design: Descriptive study (Canadian Task Force classification II-2).
Setting: University hospital.
Patients: Ten patients who underwent laparoscopic low anterior resection of intestinal endometriosis at our hospital between January 1999 and August 2007.
Intervention: Laparoscopic low anterior resection of intestinal endometriosis.
Measurements and Main Results: Mapping of endometriotic foci, degree of vertical infiltration to the intestinal layers, and longitudinal spread of endometriotic foci to the intestinal plane were defined using hematoxylin-eosin, estrogen receptor, progesterone receptor, and CD10 staining.
Results: Endometriotic foci tended to spread concentrically around a primary lesion that comprised most of a resected specimen. The deepest layer containing endometriotic foci at the primary lesion was the submucosal layer in 7 specimens (70%), and the internal circular muscle layer in 3 (30%). Satellite lesions comprising thickened areas that were independent of the primary lesion were detected in 5 specimens (50%). Multiple endometriotic foci were confirmed in all satellite lesions.
Conclusions: Endometriotic foci might not only infiltrate the primary lesion in intestinal endometriosis but also disseminate to other areas. Thus, the primary lesion of intestinal endometriosis with a large margin must be excised via low anterior resection.

• 出版日期2011-2