Low anterior resection syndrome following different surgical approaches for low rectal endometriosis: A retrospective multicenter study

Attila Bokor, Gernot Hudelist, Noémi Dobó, Bernhard Dauser, Marilena Farella, Réka Brubel, Jean‐Jacques Tuech, Jean-Jacques Tuech, Horace Roman
Acta obstetricia et gynecologica Scandinavica · 2020 · vol. 100(5) , pp. 860–867 · doi:10.1111/aogs.14046 · PMID:33188647 · W3100214579
article OA: bronze CC0 ⤵ 26 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This multicenter study found no significant difference in low anterior resection syndrome between laparoscopic-transanal disk excision and nerve- and vessel-sparing segmental resection for low rectal endometriosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

INTRODUCTION: There is increasing evidence that intermediate and long-term bowel dysfunction may occur as a consequence of radical surgery for rectal deep endometriosis (DE). Typical symptoms include constipation, feeling of incomplete evacuation, clustering of stools, and urgency. This is described in the colorectal surgical literature as low anterior resection syndrome (LARS). Within this, several studies suggested that differences regarding functional outcomes could be favorable to more conservative surgical approaches, that is, excision of endometriotic tissue with preservation of the luminal structure of the rectal wall when compared with classical segmental resection techniques for DE, especially when performed for low DE. MATERIAL AND METHODS: A total of 211 patients undergoing rectal surgery for low DE (≤7 cm from the anal verge) in three different tertiary referral centers between October 2009 and December 2018 were retrospectively reviewed regarding major complications and LARS. From the 211 eligible patients, six women were excluded because of loss to follow-up. Finally, a total number of 205 patients were enrolled for the statistical analysis; 139 with nerve- and vessel-sparing segmental resection (NVSSR) and 66 operated for laparoscopic-transanal disk excision (LTADE) were included. Gastrointestinal functional outcomes of the two procedures were compared using the validated LARS questionnaire. The median follow-up time was 46 ± 11 months. As a secondary outcome, the surgical sequelae were examined. RESULTS: We found no statistically significant difference between the incidence of LARS (31.7% and 37.9%, respectively) among patients operated by LTADE when compared with NVSSR (P = .4). The occurrence of LARS was positively associated with the use of protective ileostomy or colostomy (P = .02). A higher rate of severe complications was observed in women undergoing LTADE (19.7%) when compared with patients with NVSSR (9.0%, P = .029). CONCLUSIONS: LARS is not more frequent after NVSSR when compared with a more conservative approach such as LTADE in patients undergoing rectal surgery for low DE. To confirm our findings prospective studies are required.

My notes (saved in your browser only)

Condition tags

endometriosis

MeSH descriptors

Digestive System Surgical Procedures Endometriosis Postoperative Complications Rectal Diseases Adult Digestive System Surgical Procedures Endometriosis Female Humans Postoperative Complications Rectal Diseases Retrospective Studies Syndrome Tertiary Care Centers

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (33)

Cited by (26)

Source provenance

europepmc
last seen: 2026-06-23T06:15:44.889181+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:21:36.268089+00:00
License: CC0 · commercial use OK