Randomized Trial of Laparoscopically Assisted Versus Open Colorectal Resection for Endometriosis

Émile Daraï, Emile Daraï, Gil Dubernard, Charles Coutant, Catherine Frey, Roman Rouzier, Marcos Ballester
Annals of surgery · 2010 · vol. 251(6) , pp. 1018–1023 · doi:10.1097/sla.0b013e3181d9691d · PMID:20485146 · W2027244513
article OA: closed CC0 ⤵ 191 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This randomized trial found laparoscopically assisted colorectal resection for endometriosis offered similar symptom and quality of life improvements to open surgery but with less blood loss, fewer complications, and a higher pregnancy rate.

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Abstract

OBJECTIVE: We report the first randomized trial of laparoscopically assisted versus open colorectal resection for endometriosis focusing on perioperative complications, improvement in symptoms, quality of life, and fertility. SUMMARY OF BACKGROUND DATA: Bowel endometriosis is one of the most severe forms of endometriosis. Although laparoscopically assisted surgery is a validated technique for colorectal cancer, there are serious concerns about its appropriateness for endometriosis in young women wishing to conceive because it is almost invariably a traumatic procedure. METHODS: We conducted a noninferiority trial and randomly assigned 52 patients with colorectal endometriosis to undergo laparoscopically assisted or open colorectal resection. The median follow-up was 19 months. The primary end point was improvement in dyschesia. RESULTS: Overall, a significant improvement in digestive symptoms (dyschesia P < 0.0001, diarrhea P < 0.01, and bowel pain and cramping P < 0.0001), gynecologic symptoms (dysmenorrhea P < 0.0001 and dyspareunia P < 0.0001), and general symptoms (back pain P = 0.001 and asthenia P = 0.0001) was observed. No difference in the symptom delta values and quality of life was noted between the groups. Median blood loss was lower in the laparoscopic group (P < 0.05). Total number of complications was higher in the open surgery group (P = 0.04), especially grade 3 (P = 0.03). Pregnancy rate was higher in the laparoscopic group (P = 0.006), and the cumulative pregnancy rate was 60%. CONCLUSION: Our findings support that laparoscopy is a safe option for women requiring colorectal resection for endometriosis. Moreover, laparoscopy offers a higher pregnancy rate than open surgery with similar improvements in symptoms and in quality of life.

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Condition tags

endometriosisbowel_endometriosisdysmenorrheadyspareunia

MeSH descriptors

Colonic Diseases Endometriosis Laparoscopy Quality of Life Rectal Diseases Adult Colonic Diseases Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Postoperative Complications Pregnancy Rectal Diseases

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 (32)

Cited by (50)

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