Laparoscopic colorectal resection for endometriosis

Roberto Campagnacci, R Campagnacci, Campagnacci R, Perretta S, S Perretta, Silvana Perretta, Guerrieri M, Mario Guerrieri, M Guerrieri, A M Paganini, Alessandro M. Paganini, De Sanctis A, A. De Sanctis, A Ciavattini, Andrea Ciavattini, Lezoche E, E Lezoche, Emanuele Lezoche
Surgical endoscopy · 2005 · vol. 19(5) , pp. 662–664 · doi:10.1007/s00464-004-8710-7 · PMID:15759190 · W2086717603
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

Laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement was performed in seven patients, achieving symptom relief in 71% with no major complications.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper studied 29 consecutive patients with deep pelvic endometriosis who required laparoscopic intervention, focusing on 7 patients in whom colorectal involvement (rectosigmoid) was identified preoperatively; low anterior resection or sigmoid resection was performed in selected cases with colonoscopy showing normal mucosa in all patients. The authors report that complete laparoscopic management involved resecting the bowel segment with involvement and excising other endometriosis implants, with outcomes assessed using operative time, conversion rate, complications, length of stay, and pain relief. No anastomotic leaks or major postoperative complications occurred, with a temporary urinary retention in one patient, and at a median follow-up of 38.7 months most patients achieved complete or improved pelvic symptom relief, except one with a new colonic implant diagnosed two years later requiring reoperation. The main limitation explicitly reflected by the design is the small, single-center case series without a comparative laparoscopic-versus-open control group. This paper is centrally about endometriosis — it evaluates feasibility and effectiveness of laparoscopic colorectal resection for rectosigmoid deep pelvic endometriosis.

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Abstract

BackgroundThe rectosigmoid colon is affected by deep pelvic endometriosis in 3-37% of cases. In the past, treatment of the affected gastrointestinal tract generally required conversion to conventional surgery. We describe our experience with complete laparoscopic management of deep pelvic endometriosis with bowel involvement.MethodsFrom March 1995 to March 2003, 29 consecutive patients with endometriosis requiring laparoscopic intervention were evaluated. In seven patients (24%) colorectal involvement was identified prior to the operation. A low anterior resection was performed in four patients (57%) and a sigmoid resection in three (43%). In all cases, colonoscopy showed a normal mucosa. In all cases, treatment consisted of resection of the bowel involved together with the excision of all other implants. Data analysis included age, previous abdominal operations, previous history of endometriosis, operative time, conversion rate, complications, length of stay, and pain relief.ResultsThere were seven patients with colorectal involvement whose median age was 32.8 years (range, 28-40), with a history of previous abdominal operation in two (28%). Preoperative symptoms were as follow: dysmenorrea in four patients (57%), dyspareunia in four (57%), pelvic pain in seven (100%), rectal bleeding in one (14%), and tenesmus in five (71%). Mean operative time was 190 min (range, 165-230). Length of stay was 8.3 days (range, 7-11). There were no anastomotic leak and no major postoperative complication. One patient had temporary urinary retention. At a median follow-up of 38.7 months (range, 1-84), complete relief of pelvic symptoms was achieved in five patients (71%), and there was improvement in one patient. In one patient complaining of persistent pain, a new colonic implant was diagnosed two years after the surgery requiring reoperation.ConclusionsThe results show that provided that the surgeon is highly skilled in laparoscopy, laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement is feasible and effective in nearly all patients.
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Abstract

Background The rectosigmoid colon is affected by deep pelvic endometriosis in 3–37% of cases. In the past, treatment of the affected gastrointestinal tract generally required conversion to conventional surgery. We describe our experience with complete laparoscopic management of deep pelvic endometriosis with bowel involvement.

Methods

From March 1995 to March 2003, 29 consecutive patients with endometriosis requiring laparoscopic intervention were evaluated. In seven patients (24%) colorectal involvement was identified prior to the operation. A low anterior resection was performed in four patients (57%) and a sigmoid resection in three (43%). In all cases, colonoscopy showed a normal mucosa. In all cases, treatment consisted of resection of the bowel involved together with the excision of all other implants. Data analysis included age, previous abdominal operations, previous history of endometriosis, operative time, conversion rate, complications, length of stay, and pain relief.

Results

There were seven patients with colorectal involvement whose median age was 32.8 years (range, 28–40), with a history of previous abdominal operation in two (28%). Preoperative symptoms were as follow: dysmenorrea in four patients (57%), dyspareunia in four (57%), pelvic pain in seven (100%), rectal bleeding in one (14%), and tenesmus in five (71%). Mean operative time was 190 min (range, 165–230). Length of stay was 8.3 days (range, 7–11). There were no anastomotic leak and no major postoperative complication. One patient had temporary urinary retention. At a median follow-up of 38.7 months (range, 1–84), complete relief of pelvic symptoms was achieved in five patients (71%), and there was improvement in one patient. In one patient complaining of persistent pain, a new colonic implant was diagnosed two years after the surgery requiring reoperation.

Conclusions

The results show that provided that the surgeon is highly skilled in laparoscopy, laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement is feasible and effective in nearly all patients. Similar content being viewed by others

References

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Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_pain

MeSH descriptors

Colectomy Endometriosis Laparoscopy Rectal Diseases Sigmoid Diseases Adult Colectomy Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Feasibility Studies Female Gastrointestinal Hemorrhage Gastrointestinal Hemorrhage Humans Laparoscopy

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