Is pouch of Douglas obliteration a marker of bowel XXXX ?

@entity1 @entity249 @entity46 @entity158
STUDY OBJECTIVE: To estimate the clinical significance of pouch of Douglas (POD) obliteration in @entity1 undergoing laparoscopic excision of @entity46 . DESIGN: Prospective study (Canadian Task Force Classification II-2). SETTING: University-affiliated tertiary referral center for @entity46 . @entity1 : A total of 454 consecutive @entity1 who underwent laparoscopic surgery for treatment of pelvic @entity158 or @entity249 -associated @entity46 between October 2004 and September 2008. INTERVENTIONS: Demographic, historical, and final surgical data were compared between @entity1 with and without POD obliteration at laparoscopy. Logistic regression analyses were performed to investigate the predictive value of POD obliteration at laparoscopy with regard to bowel @entity46 . MEASUREMENTS AND MAIN RESULTS: One hundred consecutive @entity1 with POD obliteration at laparoscopy were included. 58% (95% confidence interval [CI] 0.48-0.67, n = 58/100) of the @entity1 with POD obliteration required bowel surgery compared with 20% (95% CI 0.16-0.25, 72/354) of @entity1 without POD obliteration (p <.001). Of the POD obliteration group, 66% (95% CI 0.53-0.76) required bowel shaving, 12% (0.06-0.23) full segmental rectal resection, 9% (0.04-0.19) wedge rectal resection, 5% (0.02-0.14) full segmental rectosigmoid resection and 9% (0.04-0.19) a combination of the above. Bowel @entity46 was histologically confirmed in all @entity1 . CONCLUSION: POD obliteration at laparoscopy carries a high risk of bowel @entity46 and bowel surgery. This risk is three times higher than those without POD obliteration. @entity1 with POD obliteration should be managed in tertiary referral centers for the treatment of @entity46 where colorectal input is available.
