Optimizing outcomes in laparoscopic segmental resection for bowel endometriosis

Limei Ji, Ji L, Jin L, Lanying Jin, Shao M, Mingjun Shao, Min Hu, Hu M
International Journal of Gynecology & Obstetrics · 2026 · vol. 173(1) , pp. 506–513 · doi:10.1002/ijgo.70638 · PMID:41236104
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study compared laparoscopic segmental resection with and without mesentery preservation for bowel endometriosis, finding the technique with mesentery preservation led to better outcomes and symptom improvement.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This single-center retrospective cohort study compared two laparoscopic techniques for colorectal segmental resection in 135 patients with bowel endometriosis, evaluating laparoscopic segmental resection (LscSgR) versus laparoscopic segmental resection with mesentery preservation (LscPR). After a median follow-up of 4.8 years (131 completed questionnaires), overall complications were uncommon and included pelvic encapsulated hydrops, rectovaginal fistula, and anastomotic stenosis, each reported at 2.90%. Deep endometriosis recurrence was 2.90% in LscSgR and 1.62% in LscPR, with LscPR showing significantly lower low anterior resection syndrome incidence and better bowel endometriosis symptom scores. The study’s key limitation is its retrospective design and single-center setting, with the authors noting the need for validation in larger studies. This paper is centrally about endometriosis — it directly compares laparoscopic segmental resection approaches for bowel endometriosis and evaluates recurrence, complications, and symptom outcomes.

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Abstract

OBJECTIVE: The aim of this study was to compare surgical outcomes of two laparoscopic techniques for bowel endometriosis and determine the optimal laparoscopic segmental resection technique with mesentery preservation. MATERIALS AND METHODS: This was a single-center, retrospective, two-arm cohort study. A total of 135 patients underwent colorectal segmental resection for endometriosis from January 2014 to January 2022 in the Gynecology Department at the Jinhua Maternity and Child Health Care Hospital. The enrollment inclusion criteria were as follows: nodule ≥3 cm in size, ≥50% circumference/stenosis, and >5 cm from anal verge. Outcomes of laparoscopic segmental resection (LscSgR) of endometriosis were compared to laparoscopic segmental resection of endometriosis with mesentery preservation (LscPR). All eligible patients were informed that different intestinal surgical procedures would be performed as deemed necessary by a gynecologic surgeon. RESULTS: A total of 135 patients with bowel endometriosis were enrolled and surgically treated: 72 underwent LscSgR (Group A) and 63 LscPR (Group B). After a median follow-up of 4.8 years, 131 patients completed the questionnaire. Complications included pelvic encapsulated hydrops (2.90%), rectovaginal fistula (2.90%), and anastomotic stenosis (2.90%). The recurrence rates of deep endometriosis were 2.90% in Group A and 1.62% in Group B. LscPR demonstrated significantly better outcomes than LscSgR in terms of both low anterior resection syndrome incidence and bowel endometriosis symptom scores. CONCLUSION: LscPR is an effective surgical treatment for bowel endometriosis. The initial findings from the current study suggest the potential for significant symptom improvement with a lower incidence of complications in patients undergoing LscPR for bowel endometriosis, but further validation in larger studies is warranted. The findings of the current study open new perspectives in relation to treatment of bowel endometriosis.
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Abstract

Objective The aim of this study was to compare surgical outcomes of two laparoscopic techniques for bowel endometriosis and determine the optimal laparoscopic segmental resection technique with mesentery preservation.

Materials and methods

This was a single-center, retrospective, two-arm cohort study. A total of 135 patients underwent colorectal segmental resection for endometriosis from January 2014 to January 2022 in the Gynecology Department at the Jinhua Maternity and Child Health Care Hospital. The enrollment inclusion criteria were as follows: nodule ≥3 cm in size, ≥50% circumference/stenosis, and >5 cm from anal verge. Outcomes of laparoscopic segmental resection (LscSgR) of endometriosis were compared to laparoscopic segmental resection of endometriosis with mesentery preservation (LscPR). All eligible patients were informed that different intestinal surgical procedures would be performed as deemed necessary by a gynecologic surgeon.

Results

A total of 135 patients with bowel endometriosis were enrolled and surgically treated: 72 underwent LscSgR (Group A) and 63 LscPR (Group B). After a median follow-up of 4.8 years, 131 patients completed the questionnaire. Complications included pelvic encapsulated hydrops (2.90%), rectovaginal fistula (2.90%), and anastomotic stenosis (2.90%). The recurrence rates of deep endometriosis were 2.90% in Group A and 1.62% in Group B. LscPR demonstrated significantly better outcomes than LscSgR in terms of both low anterior resection syndrome incidence and bowel endometriosis symptom scores.

Conclusion

LscPR is an effective surgical treatment for bowel endometriosis. The initial findings from the current study suggest the potential for significant symptom improvement with a lower incidence of complications in patients undergoing LscPR for bowel endometriosis, but further validation in larger studies is warranted. The findings of the current study open new perspectives in relation to treatment of bowel endometriosis. CONFLICT OF INTEREST STATEMENT We declare that there are no conflicts of interest related to this research. DATA AVAILABILITY STATEMENT All data analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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