Defining probabilities of bowel resection in deep endometriosis of the rectum: P rediction with preoperative magnetic resonance imaging

Alessio Perandini, Simone Perandini, Stefania Montemezzi, Cecilia Bonin, Gaia Bellini, Valentino Bergamini
Journal of Obstetrics and Gynaecology Research · 2017 · vol. 44(2) , pp. 292–297 · doi:10.1111/jog.13523 · PMID:29094417 · W2766434964
article OA: closed CC0 ⤵ 8 in-corpus citations
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This study developed and validated an algorithm using rectal MRI parameters, impact angle and lesion size, to predict the necessity of bowel resection in patients with deep endometriosis.

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Abstract

AIM: Deep endometriosis of the rectum is a highly challenging disease, and a surgical approach is often needed to restore anatomy and function. Two kinds of surgeries may be performed: radical with segmental bowel resection or conservative without resection. Most patients undergo magnetic resonance imaging (MRI) before surgery, but there is currently no method to predict if conservative surgery is feasible or whether bowel resection is required. The aim of this study was to create an algorithm that could predict bowel resection using MRI images, that was easy to apply and could be useful in a clinical setting, in order to adequately discuss informed consent with the patient and plan the an appropriate and efficient surgical session. METHODS: We collected medical records from 2010 to 2016 and reviewed the MRI results of 52 patients to detect any parameters that could predict bowel resection. Parameters that were reproducible and with a significant correlation to radical surgery were investigated by statistical regression and combined in an algorithm to give the best prediction of resection. RESULTS: The calculation of two parameters in MRI, impact angle and lesion size, and their use in a mathematical algorithm permit us to predict bowel resection with a positive predictive value of 87% and a negative predictive value of 83%. CONCLUSIONS: MRI could be of value in predicting the need for bowel resection in deep endometriosis of the rectum. Further research is required to assess the possibility of a wider application of this algorithm outside our single-center study.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Rectum Adult Algorithms Endometriosis Endometriosis Female Humans Laparoscopy Laparoscopy Magnetic Resonance Imaging Preoperative Care Rectal Diseases Rectal Diseases Rectum Rectum

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (8)

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