Colorectal Endometriosis: Ample data without definitive recommendations.

Gaby Moawad, G N Moawad, Jordan S. Klebanoff, J S Klebanoff, Nassir Habib, N Habib, S Bendifallah, Sofiane Bendifallah
Facts, views & vision in ObGyn · 2021 · vol. 13(1) , pp. 3–6 · doi:10.52054/fvvo.13.1.006 · PMID:33889855 · W3148883637
article OA: bronze CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper highlights the lack of definitive guidelines for colorectal endometriosis surgery and proposes an expert-opinion-based algorithm to guide preoperative assessment and surgical technique, addressing data heterogeneity and outcome variations.

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

This perspective paper examines the evidence base for preoperative work-up and the choice of surgical technique for colorectal endometriosis, noting that definitive recommendations are lacking despite ample study. It argues that evidence synthesis is difficult because comparisons are heterogeneous, outcomes differ across studies, and most data emphasize operative complications rather than preoperative assessment and technique selection. The authors highlight the need for guidelines specifying when rectovaginal shaving, discoid excision, or segmental resection should be performed, and they propose an algorithm grounded in expert opinion after synthesizing available data, with an explicit limitation that it is not derived from a uniform evidence base. This paper is centrally about endometriosis — it focuses on surgical decision-making for colorectal endometriosis and the absence of definitive evidence-based recommendations.

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Abstract

The preoperative work-up and optimal surgical approach to colorectal endometriosis is a highly studied topic lacking definitive recommendations. Synthesis of the available data can be extremely challenging for surgeons due to the heterogeneity of existing comparisons, a variety of studied surgical outcomes, and a predominant focus on operative complications. While these considerations are extremely important for surgeons performing such complex gynaecologic surgery there is still much to be desired with regards to evidence based guidelines for the preoperative assessment and surgical technique for colorectal endometriosis. Having an established guideline stating in which clinical situations endometriosis surgeons should performing rectovaginal shaving, versus discoid excision, versus segmental resection would be extremely important for all pelvic surgeons, even those operating in high-volume centres dedicated to the surgical management of complex endometriosis. This perspective highlights the shortcomings of the available data and attempts to create an algorithm surgeons can follow when performing surgery for colorectal endometriosis. This algorithm is based on our expert opinion after synthesising available data.
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Abstract The preoperative work-up and optimal surgical approach to colorectal endometriosis is a highly studied topic lacking definitive recommendations. Synthesis of the available data can be extremely challenging for surgeons due to the heterogeneity of existing comparisons, a variety of studied surgical outcomes, and a predominant focus on operative complications. While these considerations are extremely important for surgeons performing such complex gynaecologic surgery there is still much to be desired with regards to evidence based guidelines for the preoperative assessment and surgical technique for colorectal endometriosis. Having an established guideline stating in which clinical situations endometriosis surgeons should performing rectovaginal shaving, versus discoid excision, versus segmental resection would be extremely important for all pelvic surgeons, even those operating in high-volume centres dedicated to the surgical management of complex endometriosis. This perspective highlights the shortcomings of the available data and attempts to create an algorithm surgeons can follow when performing surgery for colorectal endometriosis. This algorithm is based on our expert opinion after synthesising available data.

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Condition tags

endometriosis

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.

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