Rectal Endometriosis: Results of Radical Excision and Review of Published Work

Abstract

Endometriosis of the rectum can be successfully treated with low morbidity and low recurrence rates by excising the disease as completely as possible using full-thickness excision of the anterior rectal wall or segmental resection of the rectum.

Surgical treatment of rectovaginal endometriosis with rectal involvement

“…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]. The follow-up time was not uniform within studies, neither were the criteria used to establish the diagnosis, the extent of the RVE, or the result variables.…”

“…All of them are observational studies in which the treatment option was not decided randomly; rather, it was made in terms of clinical criteria or in consensus with the patients [30,[35][36][37][38][39].…”

“…In four of these studies [30,35,37,39], they compared the postoperative results between different techniques used for RVE. Although some of the outcomes and the way they were assessed are not directly comparable between papers, one can see a tendency that points to a similar symptomatic improvement among the different techniques and a greater rate of surgical complications among the most radical approaches.…”

The Diagnosis and Management of Severe Endometriosis

“…The current literature suggests recurrence rates are significantly higher for disc excision when compared to segmental resection. 37 Segmental bowel resection involves resection of the pelvic endometriosis leaving the residual disease attached to the rectum and mobilisation of the rectal tube involving lateral and anterior retroperitoneal dissection. The bowel is then transected below the level of disease and to a clear margin above the proximal end of the disease.…”

Clinical, histopathological, radiological diagnosis of retro rectal developmental cysts, its review and differential diagnosis - A rare case report

“…They occur mostly in middle-aged women and in a 3:1 female-to-male ratio. The most important complications of these cysts are infection with a secondary fistula and malignant degeneration of enteric cysts [8][9] .…”