{"paper_id":"039aab97-58ed-4f60-a918-8ea3e0394d4c","body_text":"Abstract\nSurgical management of rectal endometriosis may employ two approaches: (i) conservative, with the preservation of overall rectal shape by either shaving or disc excision and (ii) radical, by segmental colorectal resection. There are numerous retrospective case series, a few comparative cohorts with prospective recording of data, as well as a randomized trial comparing the two approaches. The technique of segmental resection and disc excision is standardized, while that of shaving is surgeon-dependent, when related to the depth and the completeness of the excision. In outline, postoperative complications, such as bowel fistula or pelvis abscess, are more frequent when rectal lumen is opened and rectal wall sutured, which explain higher postoperative risk of complications in women managed by disc excision when compared to those undergoing shaving. Conversely, the long-term risk of local rectal recurrences seems increasing from segmental resection and disc excision to shaving. The risk of the stenosis of bowel lumen is specifically associated with segmental resection and represents a clinically relevant narrowness of colorectal anastomosis. The feasibility of each technique is still debated: for numerous authors, rectal shaving is less or not feasible in very large and deep infiltrating nodules responsible for lumen stenosis; disc excision, particularly when it employs transanal stapler, is technically challenging in nodules involving the rectum over 4–5 cm in length; segmental resection is feasible in all cases; however it seems excessive in small nodules responsible for limited infiltration of rectal wall. As regards postoperative functional outcomes, they appear not being significantly different in women undergoing conservative versus radical approaches, suggesting that rectal shape is not the unique factor conditioning bowel function.\nIn conclusion, to date, there is insufficient evidence to strongly recommend one technique over others.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nChange history\n10 September 2022\nCorrection to:\nReferences\nHudelist G, Keckstein J, Wright JT. The migrating adenomyoma: past views on the etiology of adenomyosis and endometriosis. Fertil Steril. 2009;92(5):1536–43.\nHabib N, Centini G, Lazzeri L, Amoruso N, El Khoury L, Zupi E, et al. Bowel endometriosis: current perspectives on diagnosis and treatment. Int J Women's Health. 2020;12:35–47.\nRemorgida V, Ferrero S, Fulcheri E, Ragni N, Martin DC. 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Acta Obstet Gynecol Scand. 2020.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nRoman, H., Alsalem, H., Birsan, T., Hudelist, G. (2022). Endometriosis in Reproductive Years: Surgical Management of Colorectal Endometriosis. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_16\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-97236-3_16\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-97235-6\nOnline ISBN: 978-3-030-97236-3\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}