CR02
RECTAL ENDOMETRIOSIS: THE RESULTS OF RADICAL EXCISION

Background The aim of this paper is to review the results of radical surgical excision of rectal endometriosis. Methods All cases of endometriosis involving the rectum treated by a single colorectal surgeon were identified from a prospective database and the results reviewed. Results Between 1995 and 2005, 213 rectal procedures were performed on 203 patients together with an endo‐gynaecologist. 18 cases involved dissection of endometriosis off the rectal wall, 58 involved full‐thickness excision of the anterior rectal wall and 137 segmental excisions of the rectum were performed. The mean follow‐up was 68 months (range 7–158 months). A loop ileostomy was required in 7 (5 percent) of the segmental resections. 75 percent of cases were laparoscopic. Infertility was significantly more common in the group requiring a segmental resection (P = .026) and a history of rectal pain during defecation more common in patients having dissection of endometriosis off the rectal wall (P = .031). There were no other significant differences in symptoms between the different types of rectal surgery. The morbidity for all rectal procedures was 7 percent and there was no significant difference in complication rate between the different groups. The overall rectal recurrence rate was 5 percent and was significantly more common in the group who had dissection of the endometriosis off the rectal wall (P = .004). Conclusions Endometriosis of the rectum can be successfully treated with low morbidity and low recurrence rates by excising the disease as completely as possible using full‐thickness excision of the anterior rectal wall or segmental resection of the rectum.