Laparoscopic Surgery for Colorectal Endometriosis and its Impact upon Fertility: An Updated Australian Series of 307 Cases

Abstract

12% of women diagnosed with endometriosis (3). The most commonly involved sites of intestinal endometriosis are the rectum and rectosigmoid junction (4). The management of colorectal endometriosis presents several challenges. Diagnosis is often difficult, as clinical manifestations vary considerably and are often non-specific. Features may include dysmenorrhoea, chronic pelvic pain, infertility, dyspareunia and adnexal masses, or relate more specifically to colorectal involvement such as constipation, rectal bleeding, tenesmus and dyschezia (5). There have been rare cases reported of colorectal endometriosis presenting with bowel obstruction (6, 7), colonic perforation (8) and intussusception (9). Medical management of colorectal endometriosis is not curative and may be associated with considerable side effects (10, 11). Various surgical options to treat severe disease have been described in the literature, including bowel disc excision

An eight-year retrospective analysis of laparoscopic surgery for endometriosis, outcomes and complications in a large multicenter unit

“…In the study by Darai et al [7], 10% of women who underwent laparoscopic bowel resection due to deep infiltrating endometriosis required conversion to laparotomy (7 out of 71) and had a major complication rate of 12.6%. In an Australian series by Wills et al [8], the complication rate for patients undergoing surgical removal of colorectal endometriosis was 11.4%, with a conversion to laparotomy rate of 7.5%. Magrina et al [9] reported a major complication rate of 1.4% in patients undergoing laparoscopy or robotic surgery for stage 3-4 endometriosis.…”