Impact of Bowel Endometriosis Surgery on Bowel and Bladder Function, Pain Symptoms and Quality of Life

Michalak, Katarzyna A; Cameron-Jeffs, Ruth; Yen, Aileen H.F.; Fernandes, Hilda; Shedda, Susan; Chen, Frank C.; Healey, Martin

doi:10.5301/je.5000244

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…A total number of 63 publications were included in this comprehensive review: 26 were prospective, 4,19–42 1 was a randomized controlled trial 43 and 36 were retrospective studies 1,7,16,43–75 . A total of 7549 patients presented across the 63 studies underwent segmental resection applying different techniques for colorectal endometriosis.…”

Section: Resultsmentioning

confidence: 99%

Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review

Darıcı

Salama²,

Bokor

et al. 2022

Acta Obstet Gynecol Scand

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Introduction The aim of this study was to analyze the available literature by conducting a systematic review to assess the possible effects of nerve‐sparing segmental resection and conventional bowel resection on postoperative complications for the treatment of colorectal endometriosis. Material and methods Pubmed, Clinical http://trials.gov, Cochrane Library, and Web of Science were comprehensively searched from 1997 to 2021 in order to perform a systematic review. Studies including patients undergoing segmental resection for colorectal endometriosis including adequate follow‐up, data on postoperative complications and postoperative sequelae were enrolled in this review. Selected articles were evaluated and divided in two groups: Nerve‐sparing resection (NSR), and conventional segmental resection not otherwise specified (SRNOS). Within the NSRs, studies mentioning preservation of the rectal artery supply (artery and nerve‐sparing SR – ANSR) and not reporting preservation of the artery supply (NSR not otherwise specified – NSRNOS) were further analyzed. PROSPERO ID: CRD42021250974. Results A total of 7549 patients from 63 studies were included in the data analysis. Forty‐three of these publications did not mention the preservation or the removal of the hypogastric nerve plexus, or main rectal artery supply and were summarized as SRNOS. The remaining 22 studies were listed under the NSR group. The mean size of the resected deep endometriosis lesions and patients’ body mass index were comparable between SRNOS and NSR. A mean of 3.6% (0–16.6) and 2.3% (0–10.5%) of rectovaginal fistula development was reported in patients who underwent SRNOS and NSR, respectively. Anastomotic leakage rates varied from 0% to 8.6% (mean 1.7 ± 2%) in SRNOS compared with 0% to 8% (mean 1.7 ± 2%) in patients undergoing NSR. Urinary retention (4.5% and 4.9%) and long‐term bladder catheterization (4.9% and 5.6%) were frequently reported in SRNOS and NSR. There was insufficient information about pain or the recurrence rates for women undergoing SRNOS and NSR. Conclusions Current data describe the outcomes of different segmental resection techniques. However, the data are inhomogeneous and not sufficient to reach a conclusion regarding a possible advantage of one technique over the other.

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Section: Resultsmentioning

confidence: 99%

Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review

Darıcı

Salama²,

Bokor

et al. 2022

Acta Obstet Gynecol Scand

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“…The result is an inconsistency of effect as inputs are not homogenous. In study 9, only 10% of the included patients were in the radical surgery group 30 . This leads to a risk of imprecision and a serious risk of bias as data is skewed toward the more conservative surgery groups.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 12 included studies ten were retrospective cohort studies, 11,[24][25][26][27][28][29][30][31][32] one prospective case-control study, 33 and one RCT. 12 The 11 studies (not including the RCT) included a total of 601 patients in the resection group and 1047 patients in the shaving and discoid resection group.…”

Section: Study Characteristicsmentioning

confidence: 99%

Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Heinz-Partington

Costa²,

Martins³

et al. 2021

Aust NZ J Obst Gynaeco

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Background Endometriosis of the bowel can be associated with significant morbidity. Surgery to remove it carries risks. Options include conservative shaving or discoid resection and more radical segmental bowel resection. Aims To determine if more conservative shaving or discoid bowel resection is associated with fewer risks than more radical segmental resection. Material and Methods This study is a systematic review. We considered eligible any cohort, observational or randomised controlled trial (RCT) study of at least ten women per arm comparing conservative vs radical bowel surgery for endometriosis. We divided complications into two groups, major and minor. One additional article was added due to its significance in answering our study question as well as the high quality of the study design as an RCT. Results There were 3041 studies screened. Eleven studies were included (n = 1648). For major complications, the risk ratio for shaving and disc excision vs segmental resection is 0.31 (95% CI 0.21–0.46), while the risk difference is −0.25 (95% CI −0.41 to 0.10). For minor complications, the risk ratio is 0.63 (95% CI 0.36–1.09), while the risk difference is −0.03 (95% CI −0.12 to 0.05). Conclusions Conservative shaving or discoid excision surgery is associated with reduced complications. Previous studies demonstrated a trend toward this finding, but suffered from relatively low participant numbers, increasing the risk of type one statistical error. Our results allow surgeons to make informed choices about potential complications when deciding how to approach bowel endometriosis. The results also allow patients to have more information about the risks. However, outcomes in the studies analysed are heterogenous and are from low‐quality evidence.

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Conservative versus Radical Surgery for Women with Deep Infiltrating Endometriosis: Systematic Review and Meta-analysis of Bowel Function

Quintairos¹,

Brito²,

Farah³

et al. 2022

Journal of Minimally Invasive Gynecology

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Impact of Bowel Endometriosis Surgery on Bowel and Bladder Function, Pain Symptoms and Quality of Life

Cited by 4 publications

References 42 publications

Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review

Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review

Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications

Conservative versus Radical Surgery for Women with Deep Infiltrating Endometriosis: Systematic Review and Meta-analysis of Bowel Function

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