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Improved Outcomes with Nerve-Sparing Technique: A Retrospective Comparison of Colorectal Surgeries for Bowel
Limei Ji1,2, Lanying Jin1,2, Mingjun Shao1,2
1Department of Gynecology, Jinhua Maternity and Child Health Care Hospital, Jinhua, People's Republic of China.
Study Objective:
The aim of this study was to describe surgical outcomes after different types of colorectal surgery for bowel endometriosis and to present the feasibility of LscPR in bowel endometriosis.
Design:
Retrospective analysis.
Setting:
Gynecological department at the Jinhua Maternity and Child Health Care Hospital.
Interventions And Measurements:
From January 2014 to November 2024, we recruited 320 patients with bowel endometriosis who underwent LscShR (n=108), LscDR (n=70), LscSgR (n=73), or LscPR (n=69).
Main Results:
Over a median follow-up of 4.6 years (range: 1-10 years), one patient rejected subsequent treatment in the LscShR and LscSgR groups, respectively, and two patients were lost to follow-up in the LscDR group; a total of 316 women completed the follow-up questionnaire. The total complication rate was highest in the LscSgR group (16.67%), followed by the LscDR (5.88%), LscPR (4.35%), and LscShR (1.87%) groups, with a statistically significant difference (P = 0.002). BE recurrence was seen only in the LscShR (12.15%) and LscDR (7.35%) groups (P < 0.001). DIE recurrence rates were low and similar across all groups (P = 0.810), ranging from 1.45% (LscPR) to 4.41% (LscDR). The incidence of low anterior rectal resection syndrome in the LscPR group was similar to that of the LscShR and LscDR (P > 0.05) groups, and the parameter was significantly lower than that in the LscSgR group (P < 0.05);.The LscPR surgical method was associated with the most comprehensive postoperative symptom improvement, achieving the best overall BENS scores. The rectal sensory parameters (FRS, CRS, MRTS) and the operation time of the balloon extraction test in the LscPR group were similar to those in the LscDR and LscShR groups (P > 0.05), and significantly lower than those in the LscSgR group (P < 0.05).
Conclusion:
Within the limitations of a retrospective study, our data suggest that LscPR is an effective approach for bowel endometriosis, associated with significant symptom improvement and fewer complications.
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