Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement

Abstract

Objective The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center. Methods The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated. Results One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively. Conclusion Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.

Complicações da endometriose intestinal infiltrativa profunda

“…A EIP é um dos tipos mais graves e em até 25% dos casos, afeta o intestino. As lesões podem ser únicas ou multifocais e, dependendo do sítio anatômico acometido, podem apresentar sintomas variados (Parra et al, 2022). Os sintomas mais prevalentes na EIP são dor pélvica crônica, dismenorreia e dispareunia profunda, associados ou não a sintomas intestinais como diarreia, tenesmo, disquesia, hematoquezia e constipação, que levam a uma redução na qualidade de vida, além de ser importante causa de infertilidade (Rocha et al, 2018).…”

“…A idade da paciente, a intensidade da dor, o risco de obstrução intestinal, o sangramento intestinal e o desejo de gravidez em pacientes inférteis são fatores que devem ser considerados para o manejo da EIP com envolvimento intestinal. A cirurgia é indicada principalmente em pacientes com dor pélvica que não respondem à terapia medicamentosa e naquelas com desejo de gravidez (Parra et al, 2022).…”

Role of robot-assisted laparoscopy in deep-infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

“…However, the increased prevalence of segmental resections within the SLS cohort itself introduces a potential confounding variable, given its association with prolonged surgical duration and an increased risk of postoperative complications. (41,42). These factors can naturally in uence other surgical outcomes, such as recovery times and complication rates.…”

Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework

“…However, the increased prevalence of segmental resections within the SLS cohort itself introduces a potential confounding variable, given its association with prolonged surgical duration and an increased risk of postoperative complications [ 41 , 42 ]. These factors can naturally influence other surgical outcomes, such as recovery times and complication rates.…”