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Deep shaving and transanal disc excision in large endometriosis of mid and lower rectum: the Rouen technique

Overview of attention for article published in Surgical Endoscopy, September 2015
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21 Mendeley
Title
Deep shaving and transanal disc excision in large endometriosis of mid and lower rectum: the Rouen technique
Published in
Surgical Endoscopy, September 2015
DOI 10.1007/s00464-015-4528-8
Pubmed ID
Authors

Horace Roman, Carole Abo, Emmanuel Huet, Jean-Jacques Tuech

Abstract

Colorectal resection is performed in a majority of patients presenting with large endometriosis of mid and lower rectum; however, it may negatively and irreversibly impact postoperative rectal function. To avoid such unfavourable outcomes, we propose an original technique combining laparoscopic deep rectal shaving and transanal disc excision using a semi-circular stapler. The video presents the procedure performed in a 29-year-old nullipara referred with a large endometriotic nodule infiltrating the lower rectum on more than 30 mm length. The first step is laparoscopic and involves deep rectal shaving performed using exclusively the plasma energy. Then, transanal excision of shaved area is performed, by placing traction parachute sutures in the middle and outside the shaved area. Their traction induces the prolapse of shaved area that is resected using a semicircular stapler. Insufflating the rectum with air checks the integrity of the staple line. Operative time was 210 min. Immediate postoperative outcomes were uneventful, and bowel movements were normal beginning with day 6. Our technique is suitable in large rectal nodules located up to 10 cm above the anus, infiltrating the rectum on up to 6 cm length, and these parameters are preoperatively assessed using MRI and computed tomography. To date, it was successfully carried out in 29 women with large deep endometriosis of the mid and lower rectum. Rectovaginal fistula was recorded in one patient (3.6 %) and transitory bladder dysfunction in seven patients (25 %). Digestive function assessment using standardized questionnaires revealed an overall improvement, without de novo anal continence troubles. Postoperative pregnancy rate was 78 % with a majority of patients having conceived spontaneously. Based on our experience, we believe that our conservative technique is feasible and reproducible in large mid and lower rectal endometriosis and might avoid the risk of unfavourable outcomes related to low colorectal resection.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 29%
Student > Bachelor 2 10%
Student > Doctoral Student 2 10%
Student > Ph. D. Student 2 10%
Student > Master 2 10%
Other 3 14%
Unknown 4 19%
Readers by discipline Count As %
Medicine and Dentistry 9 43%
Unspecified 2 10%
Immunology and Microbiology 1 5%
Agricultural and Biological Sciences 1 5%
Unknown 8 38%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 August 2016.
All research outputs
#9,433,965
of 12,308,667 outputs
Outputs from Surgical Endoscopy
#2,645
of 3,596 outputs
Outputs of similar age
#172,801
of 266,764 outputs
Outputs of similar age from Surgical Endoscopy
#84
of 152 outputs
Altmetric has tracked 12,308,667 research outputs across all sources so far. This one is in the 20th percentile – i.e., 20% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,596 research outputs from this source. They receive a mean Attention Score of 3.7. This one is in the 19th percentile – i.e., 19% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,764 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 29th percentile – i.e., 29% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 152 others from the same source and published within six weeks on either side of this one. This one is in the 34th percentile – i.e., 34% of its contemporaries scored the same or lower than it.