Complications Associated With Two Laparoscopic Procedures Used in the Management of

Background: To evaluate intra- and postoperative com-plications associated with laparoscopic management of rectal endometriosis by either colorectal segmental resec-tion or nodule excision. Methods: During 39 consecutive months, 46 women un-derwent laparoscopic management of rectal endometrio-sis and were included in a retrospective comparative study. The distinguishing feature of the study is that the choice of the surgical procedure is not related to the characteristics of the nodule. Results: Colorectal segmental resection with colorectal anastomosis was carried out in 15 patients (37%), while macroscopically complete rectal nodule excision was per-formed in 31 women (63%). No intraoperative complica-tions were recorded. In the colorectal resection group, 3 women (18%) had a bladder atony (spontaneously regres-sive in 2 women), 4 women (24%) experienced chronic constipation, one had an anastomosis leakage (6%), while 2 women (13%) had acute compartment syndrome with peripheral sensory disturbance. In the nodule excision group, 1 woman (4%) developed transitory right obturator nerve motor palsy. Based on both postoperative pain and improvement in quality of life, all 29 women in the exci-sion group (100%) and 14 women in the colorectal resec-tion group (82%) would recommend the surgical proce-dure to a friend suffering from the same disease. Conclusion: Our study suggests that carrying out colo-rectal segmental resection in rectal endometriosis is asso-ciated with unfavourable postoperative outcomes, such as bladder and rectal dysfunction. These outcomes are less likely to occur when rectal nodules are managed by ex-cision. Information about complications related to both surgical procedures should be provided to patients man-aged for rectal endometriosis and should be taken into account when a decision is being made about the most appropriate treatment of rectal endometriosis in each case.