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Updated: Jan 29, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Role of protective defunctioning stoma in colorectal resection for endometriosis
Jérémie Belghiti1, Marcos Ballester1, Sonia Zilberman1
1Departments of Obstetrics and Gynecology, GRC 6-UPMC, Centre Expert En Endometriose (C3E), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université-Pierre-et-Marie-Curie-Paris VI, Paris, France.
Study Objective:
To evaluate the role of protective defunctioning stoma (PDS) on the occurrence of digestive tract complications after colorectal resection to treat endometriosis.
Design:
Prospective cohort study (Canadian Task Force classification II-2).
Setting:
University hospital.
Patients:
All patients undergoing segmental colorectal resection to treat colorectal endometriosis with and without PDS between 2003 and 2011 at Tenon University Hospital, Paris, France.
Measurements And Main Results:
Patients were assessed at 1, 6, and 12 months postoperatively and each year thereafter. Median follow-up was 60 months. Of 198 patients included for analysis, 53 (27%) had PDS. Overall, 15 (7.5%) digestive tract complications occurred: 9 (4.5%) rectovaginal fistulas and 6 (3%) anastomotic leakages. All rectovaginal fistulas occurred in patients with a low colorectal anastomosis (p < .001) and 88% (8 of 9) in patients with a partial colpectomy (p < .001). PDS was associated with a decrease in the number of rectovaginal fistulas in women undergoing partial colpectomy and low colorectal resection from 27% to 15%, without reaching significance (p = .4). No anastomotic leakage occurred in patients with PDS.
Conclusion:
Our results support that PDS can be omitted in patients with mid-colorectal anastomosis without partial colpectomy. In patients requiring partial colpectomy or partial colpectomy plus low colorectal anastomosis, PDS remains questionable.
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