Conservative versus Radical Surgery for Women with Deep Infiltrating Endometriosis: Systematic Review and Meta-analysis of Bowel Function

Ricardo de Almeida Quintáiros, Ricardo de Almeida Quintairos, Luiz Gustavo Oliveira Brito, Daniela Farah, Helizabet Salomão Abdalla Ayroza Ribeiro, Helizabet Salomao Abdalla Ayroza Ribeiro, Paulo Augusto Ayroza Galvao Ribeiro, Paulo Ayroza Ribeiro
Journal of minimally invasive gynecology · 2022 · vol. 29(11) , pp. 1231–1240 · doi:10.1016/j.jmig.2022.09.551 · PMID:36184064 · W4298009346
meta-analysis OA: closed CC0 ⤵ 12 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review and meta-analysis compared conservative and radical surgical approaches for deep infiltrating endometriosis in women, focusing on their impact on bowel function.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

OBJECTIVE: To assess bowel function in women with deep infiltrating endometriosis according to surgical approach (radical vs conservative). DATA SOURCES: Five databases were searched from 1970 to September 2021 to retrieve studies comparing radical (colorectal segmental resection) and conservative (shaving or discoid excision) surgery for bowel function in women with deep infiltrating endometriosis. METHODS OF STUDY SELECTION: No language restriction was applied. Two reviewers extracted and combined data from the included studies, applying a meta-analytic model with random effects in all calculations. Results are expressed in risk ratio (RR) with 95% confidence interval (CI). Assessment of risk of bias and quality of evidence was performed by the Newcastle-Ottawa and Grading of Recommendations, Assessment, Development and Evaluation, respectively. TABULATION, INTEGRATION, AND RESULTS: We included 13 studies in our meta-analysis, and most of them were of nonrandomized design. Conservative surgery had fewer events of constipation and frequent bowel movements when compared with radical surgery (RR, 2.31; 95% CI, 1.21-4.43; I2 = 0%; 3 studies; RR, 2.80; 95% CI 1.17-6.75; I2 = 0%; 2 studies, respectively). Defecation pain, anal incontinence loss, minor and major lower anterior resection syndrome, and Clavien-Dindo complications grade I to IV showed no statistically significant difference between surgeries. Grading of Recommendations, Assessment, Development and Evaluation assessment was low to very low for all outcomes. CONCLUSION: Conservative surgery (shaving or discoid excision) presented fewer events of constipation and frequent bowel movements than colorectal segmental resection. There was a very low quality of evidence to provide recommendations regarding bowel function.

My notes (saved in your browser only)

Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures

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 (27)

Cited by (12)

Source provenance

europepmc
last seen: 2026-06-13T17:20:28.795615+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-06-13T17:20:06.529727+00:00
License: CC0 · commercial use OK