Loading...
2 results
Search Results
Now showing 1 - 2 of 2
- Bowel anastomosis leakage following endometriosis surgery: an evidence based analysis of risk factors and prevention techniquesPublication . Vigueras Smith, A; Sumak, R.; Cabrera, R.; Ferreira, HelderBackground: Deep endometriosis most commonly involves the rectosigmoid junction and its management often requires a colorectal resection. Anastomotic leakage is a severe complication after resection and affects 1-6% of the cases. Objective: To evaluate the risk factors related to anastomotic leakage following endometriosis sur-gery, its prevention techniques and the role of protective stomas. Methods: A comprehensive literature review was carried out for English-language publications in Pubmed and Google Scholar. We included all studies including the following MeSH terms and key words: Anastomotic leakage AND bowel surgery OR Endometriosis OR Colorectal surgery OR Bowel endometriosis. Two authors independently made a selection and analysed relevant abstracts according to the aim of this review. Results: Risk factors and preventive measures were categorised considering the patient condition, the intra- operative setting and the surgical procedure itself. Level I and II recommendations include modifiable risk factors such as the use of stapled or handsewn anastomosis; intra-operative air leak test to check the integrity of the anastomosis; systematic use of pelvic and trans-anal drainage; application of protective or ghost ileostomy in low rectal resections; vaginal closure before the bowel resection; use of oral antibiotics the day before surgery and performing partial mesorectal resection near the bowel wall. Diverting stomas may decrease the morbidity and the clinical consequences of leakage over 65% of low rectal resections but may cause significant adverse effects. Conclusion: Evidence-based protective actions are crucial to reduce clinical consequences of anastomotic leakage and to minimise the use of protective stomas in endometriosis surgery.
- Psychological Morbidity in Endometriosis: A Couple’s StudyPublication . Pereira, Maria Graça; Ribeiro, Inês; Ferreira, Helder; Osório, Filipa; Nogueira-Silva, Cristina; Almeida, Ana C.Endometriosis is a chronic gynecological disease that impacts more than 176 million women worldwide, having a strong impact on psychological morbidity. This study aimed to evaluate the contribution of psychological morbidity, in women with endometriosis, taking into consideration the duration of the couple's relationship and the duration of the disease and also examined whether women's sexual satisfaction had an impact on their psychological morbidity (actor effect) and on their sexual partners' psychological morbidity (partner effect) and vice versa. Participants were 105 women and their partners, who answered the Hospital Anxiety and Depression Scale (HADS); Couple Satisfaction Index (CSI-4) and the Global Measure of Sexual Satisfaction (GMSEX). The results revealed a direct effect between the perception of symptom severity, marital satisfaction, and women's psychological morbidity. Sexual activity and the presence of infertility had an indirect effect on the relationship between sexual satisfaction, diagnosis duration, and psychological morbidity, respectively. Finally, women's sexual satisfaction had a direct effect on their own and their partner's marital satisfaction that predicted less psychological morbidity, in both. Thus, a multidisciplinary intervention focused on the couple's sexual and marital relationship is needed to promote psychological well-being in this population.