A quality-of-life meta-analysis comparing pre- and postoperative symptoms in women undergoing colorectal resection for deep infiltrating endometriosis

Barry Maguire, Alison DeMaio, Aoife O'Neill, Cillian Clancy
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025 · vol. 27(2) , pp. e70036 · doi:10.1111/codi.70036 · PMID:39980238
meta-analysis OA: closed public-domain-us
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This meta-analysis of fourteen studies found that colorectal resection for deep infiltrating endometriosis significantly improved patient-reported quality of life, pain, and gastrointestinal function, with no change in low anterior resection syndrome scores.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This paper conducted a registered, PRISMA-guided systematic review and meta-analysis of comparative studies reporting pre- and postoperative quality-of-life and symptom outcomes after colorectal resection for deep infiltrating endometriosis, combining data from 14 studies (1142 patients) using random-effects models. It found colorectal resection was associated with improved SF-36 quality-of-life scores across all items and improvements in symptoms including dysmenorrhoea, chronic pelvic pain, and deep dyspareunia, with significant gains in gastrointestinal QoL index and dyschezia. Low anterior resection syndrome scores did not change significantly. The paper is limited by relying on the available comparative evidence summarized in the included studies rather than directly analyzing new patient data. This paper is centrally about endometriosis — it meta-analyzes quality-of-life and symptom changes after colorectal resection for deep infiltrating endometriosis.

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Abstract

AIM: Deep infiltrating endometriosis (DIE) may involve the rectum or colon and is associated with pain, gastrointestinal dysfunction and reduced quality of life (QoL). While hormonal treatment may be effective, surgical intervention including colorectal resection can be required. Colorectal resection can result in functional changes and complications, which can also impair QoL. The aim of this study is to examine all available comparative pre- and postoperative data on QoL and symptom outcomes following colorectal resection for DIE. METHOD: An electronic database search was conducted for studies reporting pre- and postoperative QoL and symptom outcomes following colorectal resection for DIE. The study was registered with PROSPERO and followed PRISMA (Preferred Reporting Items in Systematic Reviews and Meta-analyses) guidelines. Data were combined using random-effects models. RESULTS: Fourteen studies including 1142 patients were included. Colorectal resection was associated with improved outcomes for all items in the SF-36 QoL questionnaire as well as symptom outcomes including dysmenorrhoea, chronic pelvic pain and deep dyspareunia. Importantly, the gastrointestinal QoL index was significantly improved (mean difference 24.50, 95% CI 15.93-33.08, p < 0.0001) as was dyschezia (mean difference -4.1, 95% CI -4.77 to -3.42, p < 0.0001). There was no change in low anterior resection syndrome scores (mean difference -5.28, 95% CI -11.65 to 1.10, p = 0.1046). CONCLUSION: This study demonstrates a significant postoperative improvement in patient-reported QoL, pain symptoms and gastrointestinal function following colorectal resection for endometriosis.
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Abstract

Aim Deep infiltrating endometriosis (DIE) may involve the rectum or colon and is associated with pain, gastrointestinal dysfunction and reduced quality of life (QoL). While hormonal treatment may be effective, surgical intervention including colorectal resection can be required. Colorectal resection can result in functional changes and complications, which can also impair QoL. The aim of this study is to examine all available comparative pre- and postoperative data on QoL and symptom outcomes following colorectal resection for DIE.

Method

An electronic database search was conducted for studies reporting pre- and postoperative QoL and symptom outcomes following colorectal resection for DIE. The study was registered with PROSPERO and followed PRISMA (Preferred Reporting Items in Systematic Reviews and Meta-analyses) guidelines. Data were combined using random-effects models.

Results

Fourteen studies including 1142 patients were included. Colorectal resection was associated with improved outcomes for all items in the SF-36 QoL questionnaire as well as symptom outcomes including dysmenorrhoea, chronic pelvic pain and deep dyspareunia. Importantly, the gastrointestinal QoL index was significantly improved (mean difference 24.50, 95% CI 15.93–33.08, p < 0.0001) as was dyschezia (mean difference −4.1, 95% CI −4.77 to −3.42, p < 0.0001). There was no change in low anterior resection syndrome scores (mean difference −5.28, 95% CI −11.65 to 1.10, p = 0.1046).

Conclusion

This study demonstrates a significant postoperative improvement in patient-reported QoL, pain symptoms and gastrointestinal function following colorectal resection for endometriosis. CONFLICT OF INTEREST STATEMENT There are no conflicts of interest. DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_paindie_deep_infiltrating

MeSH descriptors

Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy

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europepmc
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