Bowel resection for deep endometriosis: a systematic review

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Oncology

Background:

• Deep endometriosis frequently necessitates segmental bowel resection.
• Low anterior resections for non-endometriosis indications are linked to significant long-term functional complications.

Purpose of the Study:

• To systematically review segmental bowel resections for endometriosis.
• To analyze indications, outcomes, and complications based on resection level and nodule volume.

Main Methods:

• Systematic review of published articles from 1997-2009.
• Searched MEDLINE, EMBASE, and ISI Web of Knowledge databases.
• Included articles with >5 bowel resections for endometriosis and detailed endpoints.

Main Results:

• 1889 bowel resections were identified across 34 articles.
• Indications and lesion details were poorly reported; surgery varied.
• Pain relief was excellent initially, but recurrence occurred; complication rates were comparable to other bowel resections.

Conclusions:

• Indications for segmental resection in endometriosis were poorly documented.
• Data did not allow analysis by localization or diameter.
• Postoperative complication rates were comparable to other bowel resections; sexual dysfunction data was absent.