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Long-term outcome after laparoscopic bowel resections for deep infiltrating endometriosis: a single-center experience
Giacomo Ruffo1, Filippo Scopelliti1, Alberto Manzoni1
1Department of General Surgery, Sacro Cuore Don Calabria General Hospital, Via Don A. Sempreboni 5, 37024 Negrar, Italy.
Background:
Laparoscopic bowel resections for endometriosis are safe and effective but only short-term follow-up has been evaluated. In the present study long-term outcome in terms of intestinal and urinary function, fertility, chronic pain, and recurrence was assessed.
Materials And Methods:
From January 2002 to December 2010 nine hundred patients underwent laparoscopic bowel resection for endometriosis, and on 774 (86%) a questionnaire was administered. Patients were divided into 3 groups on the strength of the operation date. Postoperative diarrhea, constipation, rectal bleeding, tenesmus, dyschezia, dysuria, dyspareunia, fertility, and recurrence of disease were assessed.
Results:
The median follow-up was 54 months (range 1-120). All the evaluated symptoms significantly improved over time, with P = 0.0001 for dyspareunia, constipation, and pelvic pain and P = 0.004 for diarrhea. Nonsignificant improvement was reported for dysuria and rectal bleeding (with P = 0.452 and P = 0.097, resp.).
Conclusions:
The present results confirm that bowel resections for endometriosis are correlated with an acceptable complication rate even at long-term follow-up and that symptoms significantly improve over time, except for rectal bleeding and dysuria, the latter associated with a neurological damage.
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