Should the Gynecologist Perform Laparoscopic Bowel Resection to Treat Endometriosis? Results Over 7 Years in 168 Patients

Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial

“…Nevertheless, the ''classic'' Redwine technique for eradicating DIE has proven to be effective and is still the most commonly performed technique, adopted by the majority of endometriosis surgical teams and also by several surgeons in our institution [5,20,[35][36][37][38][39][40][41][42][43][44][45][46][47].…”

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].…”

“…In 2009, Pereira et al [54] analyzed the postoperative results of 168 women with RVE in which the intervention was conducted by gynecologists, without the initial participation of colorectal surgeons. In these patients, the interventions included shaving resection, discoid resection, and segmental resection.…”

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

“…The treatment for severe endometriosis, particularly in patients with DIE involving the bowel, is often complex and may require a multidisciplinary surgical approach for symptomatic patients who do not improve with medical treatment [16][17][18]. Several case series involving segmental bowel resection for DIE have been reported in the literature, but these have been limited owing to a lack of validated questionnaires, small sample size, or absence of a control group that did not undergo bowel surgery [10,[19][20][21][22][23][24][25][26][27][28]. Moreover, some studies have lacked longterm follow-up [23,28].…”