Optimizing outcomes in laparoscopic segmental resection for bowel endometriosis.

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures
• Endometriosis Research

Background:

• Bowel endometriosis presents significant challenges in surgical management.
• Laparoscopic techniques are increasingly utilized for treating deep infiltrating endometriosis.
• Optimizing surgical approaches is crucial for improving patient outcomes and reducing recurrence.

Purpose of the Study:

• To compare the surgical outcomes of two laparoscopic techniques for bowel endometriosis.
• To determine the optimal laparoscopic segmental resection technique with mesentery preservation.
• To evaluate the efficacy of LscPR versus LscSgR in managing bowel endometriosis.

Main Methods:

• A retrospective, two-arm cohort study involving 135 patients with bowel endometriosis.
• Comparison of laparoscopic segmental resection (LscSgR) versus laparoscopic segmental resection with mesentery preservation (LscPR).
• Inclusion criteria: nodule ≥3 cm, ≥50% circumference/stenosis, >5 cm from anal verge.

Main Results:

• LscPR (63 patients) demonstrated significantly better outcomes than LscSgR (72 patients).
• Lower incidence of low anterior resection syndrome and improved bowel endometriosis symptom scores were observed with LscPR.
• Recurrence rates were 1.62% for LscPR and 2.90% for LscSgR; overall complication rates were similar.

Conclusions:

• Laparoscopic segmental resection with mesentery preservation (LscPR) is an effective surgical treatment for bowel endometriosis.
• LscPR shows potential for significant symptom improvement and a lower complication incidence.
• Further validation in larger studies is warranted to confirm these findings.