Laparoscopic treatment of deep endometriosis with segmental colorectal resection: Short-term morbidity

The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions

“…When colorectal resection is performed, post-operative complications include a higher rate of functional digestive and urinary outcomes [8]. In one series, major complications requiring further surgery occurred in 10.4% of patients and included: anastomotic leakage (4.7%), rectovaginal fistula (2.7%), anastomotic fistula (2%), perforation (0.5%), bowel obstruction (0.5%), uroperitoneum (1.5%), ureteral fistula (1%), bladder fistula (0.5%), pelvic abscess (0.5%), sepsis (0.5%), hemoperitoneum (2%), heterologous blood transfusion (6%), and, after 30 days, urinary retention (4.7%), constipation (2.6%) and peripheral sensory disturbance (1.5%) [9].…”

Surgical treatment of rectovaginal endometriosis with rectal involvement

“…There were also five nonsystematic revisions published [3,28,[32][33][34]. In some of the studies, a radical treatment was assessed [5,13,15,[25][26][27][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56], while others assessed a conservative one [57][58][59][60][61][62][63]. There were six nonrandomized papers in which groups of patients with different therapeutic options were compared [30,[35][36][37][38][39].…”

“…Initially, the majority of papers defended a conservative surgical approach directed toward the extirpation or ablation of the endometriosic lesions with minimal excisional surgery of the rectum [6,12,[65][66][67][68]. However, in the last decade, multiple authors have proposed more aggressive techniques including intestinal resection, especially in those cases with an affected muscularis propia of the rectum but also in those having an intact mucosa [5,13,15,[25][26][27][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. The argument used for the practice of this radical surgery is that of achieving the greatest resection possible of the endometriosic lesions, diminishing the postoperative symptomatology and avoiding any early relapse of the disease [41,42].…”

Assessment of Long-Term Bowel Symptoms After Segmental Resection of Deeply Infiltrating Endometriosis: A Matched Cohort Study

“…Bowel resection for endometriosis can be done open or with laparoscopic assistance, with similar outcomes [7]. Complications from the procedure can be considerable, including anemia requiring blood transfusion, anastomotic leakage, fistula formation, and bowel perforation or obstruction [8][9][10]. Given the significant morbidity associated with bowel resection, the symptomatic benefits need to outweigh the risks of surgery.…”