Outcome of laparoscopic colorectal resection for endometriosis

Endometriosis is a frequent gynaecological disorder in young women. Colorectal endometriosis accounts for about 90% of all intestinal locations. The effectiveness of medical therapies is poor, and surgery, including colorectal resection, is therefore often required. Since the first description of laparoscopic colorectal resection by Redwine and Sharp, the feasibility of this approach has been confirmed by several teams but remains a matter of debate.

A review of the literature showed that conversion to laparotomy was necessary in 7.8% of cases. Segmental colorectal resection appears to be the best option, owing to the risk of incomplete resection in the case of full-thickness disc or superficial-thickness excision. However, complications are more frequent with segmental resection than with other procedures, and include de-novo urinary disorders. Laparoscopic colorectal resection for endometriosis is associated with symptom relief and a significant improvement in quality of life. In addition, 44.6% of women wishing to conceive were able to do so.

Laparoscopic colorectal resection for endometriosis appears to be an adequate alternative to laparotomy. Further studies are required to identify objective criteria with which to select women most likely to benefit from this surgery, which must be performed in special units.