Hum. Reprod. Advance Access originally published online on May 5, 2005
Human Reproduction 2005 20(8):2317-2320; doi:10.1093/humrep/dei047
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How complete is full thickness disc resection of bowel endometriotic lesions? A prospective surgical and histological study
1 Department of Obstetrics and Gynaecology, 2 Department of General Surgery and Transplant, San Martino Hospital and University of Genoa, Largo R. Benzi 1, 16132 Genoa and 3 Di.C.M.I., Unit of Anatomy and Histopathology, San Martino Hospital and University of Genoa, Via De Toni 14, 16132 Genoa, Italy
4 To whom correspondence should be addressed. Email: vremorgida{at}yahoo.it
BACKGROUND: This study aims to evaluate the completeness of full thickness disc resection in the treatment of deep endometriotic bowel lesions. METHODS: This study comprised 16 women with bowel endometriotic lesions requiring segmental resection. For the purpose of the study, before intestinal resection, nodulectomy was performed. The presence of endometriotic infiltration in direct continuity with the removed nodule and the presence of fibrosis in the area surrounding the nodule were histologically evaluated. RESULTS: In seven out of 16 cases (43.8%; 95% CI, 19.8–70.1), endometriosis was found in the bowel wall adjacent to the site of nodulectomy; the infiltration was visible in the muscular layer in all cases. In cases of incomplete nodulectomy, the muscular layer of the bowel segment surrounding the endometriotic nodule contained limited or no fibrosis. CONCLUSIONS: Full thickness disc resection is not complete in 
40% of women with bowel endometriosis. Our finding that fibrosis in the muscular layer, the main landmark during surgical resection, does not always surround bowel endometriotic lesions might explain why incomplete resection may occur.
Key words: bowel endometriosis/bowel resection/fibrosis/full thickness disc resection/laparoscopy
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