Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case-control study

Area of Science:

• Gynecology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Deep infiltrating endometriosis (DIE) and intestinal endometriosis pose significant challenges in treatment.
• Rectosigmoid segmental resection is a traditional surgical approach for intestinal DIE.
• Alternative surgical techniques are being explored to improve patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of laparoscopic discoid resection for DIE.
• To compare discoid resection with rectosigmoid segmental resection for intestinal endometriosis.
• To determine if discoid resection is a valid alternative surgical option.

Main Methods:

• A case-control study involving 136 women with DIE and intestinal endometriosis.
• Patients underwent either laparoscopic discoid rectosigmoid resection (48 patients) or segmental resection (88 patients).
• Short- and long-term outcomes were assessed, including operative time, complications, and recurrence rates.

Main Results:

• Discoid resection group: median operating time 200 minutes, blood loss 203 mL, ileus 3 days, hospitalization 7 days.
• Early complications in 12.5% of the discoid group, requiring surgical management in 4.16%.
• Recurrence rate of 10.4% in the discoid group over a median follow-up of 33 months, with fewer long-term bladder dysfunctions compared to segmental resection.

Conclusions:

• Laparoscopic mechanical discoid resection is a feasible surgical technique for deep infiltrating endometriosis.
• This method significantly improves endometriosis-related symptoms.
• Discoid resection is a worthy alternative to classic segmental resection in selected patients with intestinal endometriosis.