Rectal disc resection improves stool frequency in patients with deep infiltrating endometriosis: A prospective study

Abstract

Background: Gastrointestinal symptoms occur with deeply infiltrating endometriosis (DIE) of the rectum. Aims:To explore the medium-term gastrointestinal functional outcomes after rectal disc resection for endometriosis. Methods:All women undergoing laparoscopy for stage IV endometriosis at a tertiary referral hospital between November 2016 and January 2018 and had evidence of DIE of the rectum were included. Low anterior resection syndrome (LARS) score was measured using a validated questionnaire.Results: Thirty-six women formed the cohort of the study. The mean age was 37 years (range 20-72 years). All women underwent a laparoscopic anterior rectal disc resection for DIE. The response rate was 100%. There was an increase in the percentage of patients having no LARS postoperatively compared to preoperatively (an increase of 78-83%). There was a reduction in LARS scores postoperatively observed in 18 patients (50%) and the prevalence of major LARS decreased postoperatively from 10% to 1%. Comparison of individual symptoms revealed a significant improvement in postoperative stool frequency scores (P = 0.02). Multivariate analysis using logistic regression analysis demonstrated that reduction in postoperative stool frequency scores remained an independent factor (P = 0.008). Conclusion:Rectal disc resection is feasible and safe, achieving observable improvements in stool frequency in patients with rectal DIE. K E Y W O R D S endometriosis, rectum, deep infiltrating endometriosis, surgery

Low anterior resection syndrome following different surgical approaches for low rectal endometriosis: A retrospective multicenter study

“…In a recent meta‐analysis 19 the prevalence of major LARS after low rectum resection was as high as 41% among patients treated for colorectal cancer. Although a lot is known about the incidence of LARS after colorectal cancer surgery, evidence concerning the use of LARS after colorectal resection for DE on the basis of symptoms and quality of life is scarce, especially for a high‐risk patient group with low rectal resections resulting in anastomotic lines within 7 cm from the anus 13,20,21 . Hence, the aim of the present work was to compare two surgical approaches (LTADE and NVSSR) for full‐thickness excision of rectal DE with an anastomotic height ≤7 cm distance from the anal verge with regards to the incidence of LARS, postoperative outcomes, and fertility results.…”

The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

“…Other positive aspects reported by participants who showed improvement in pain after surgery were increased willingness to carry out daily activities, increased physical activity, better performance at work and improved sexual intercourse. A study ( 26 ) aimed to evaluate pelvic pain and quality of life before and after videolaparoscopy for deep endometriosis, also being significant improvement in the activities mentioned above was observed 1 year after surgery. It was not possible to assess improvement in infertility due to the post-surgery time of 6 months, at which point patients complaining of infertility would begin new attempts to get pregnant.…”