Colorectal resection in deep pelvic endometriosis: Surgical technique and post-operative complications

Marco Milone, Milone M, Andrea Vignali, Vignali A, Milone F, Francesco Milone, Giusto Pignata, Elmore U, Ugo Elmore, Mario Musella, Musella M, Giuseppe De Placido, Antonio Mollo, Fernandez LM, Loredana Maria Sosa Fernandez, Coretti G, Guido Coretti, Umberto Bracale, Riccardo Rosati
World journal of gastroenterology · 2015 · vol. 21(47) , pp. 13345 · doi:10.3748/wjg.v21.i47.13345 · PMID:26715819 · PMC4679768 · W2214392993
article OA: hybrid CC0 ⤵ 22 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that endometriosis localization from the anal verge, but not surgical technique, was associated with post-operative complications following laparoscopic colorectal resection for deep pelvic endometriosis.

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Abstract

AIM: To investigate the impact of different surgical techniques on post-operative complications after colorectal resection for endometriosis. METHODS: A multicenter case-controlled study using the prospectively collected data of 90 women (22 with and 68 without post-operative complications) who underwent laparoscopic colorectal resection for endometriosis was designed to evaluate any risk factors of post-operative complications. The prospectively collected data included: gender, age, body mass index, American Society of Anesthesiologists risk class, endometriosis localization (from anal verge), operative time, conversion, intraoperative complications, and post-operative surgical complications such as anastomotic dehiscence, bleeding, infection, and bowel dysfunction. RESULTS: A similar number of complicated cases have been registered for the different surgical techniques evaluated (laparoscopy, single access, flexure mobilization, mesenteric artery ligation, and transvaginal specimen extraction). A multivariate regression analysis showed that, after adjusting for major clinical, demographic, and surgical characteristics, complicated cases were only associated with endometriosis localization from the anal verge (OR = 0.8, 95%CI: 0.74-0.98, P = 0.03). After analyzing the association of post-operative complications and each different surgical technique, we found that only bowel dysfunction after surgery was associated with mesenteric artery ligation (11 out of 44 dysfunctions in the mesenteric artery ligation group vs 2 out of 36 cases in the no mesenteric artery ligation group; P = 0.03). CONCLUSION: Although further randomized clinical trials are needed to give a definitive conclusion, laparoscopic colorectal resection for deep infiltrating endometriosis appears to be both feasible and safe. Surgical technique cannot be considered a risk factor of post-operative complications.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Colectomy Colonic Diseases Endometriosis Laparoscopy Mesenteric Arteries Postoperative Complications Rectal Diseases Adult Blood Loss, Surgical Case-Control Studies Chi-Square Distribution Colectomy Colectomy Colonic Diseases Colonic Diseases Endometriosis Endometriosis Female Humans Ileostomy

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