Vascular- and nerve-sparing bowel resection for deep endometriosis: A retrospective single-center study

Manuel Maria Ianieri, Alessandra De Cicco Nardone, Alessandra Nardone, Benvenga G, Greta Benvenga, Pierfrancesco Greco, Pia Clara Pafundi, Pafundi PC, Alesi MV, Maria Vittoria Alesi, Campolo F, Federica Campolo, Claudio Lodoli, Lodoli C, Carlo Abatini, Attalla El Halabieh M, Miriam Attalla El Halabieh, Pacelli F, Fabio Pacelli, Scambia G, Giovanni Scambia, Santullo F, Francesco Santullo
International Journal of Gynecology & Obstetrics · 2023 · vol. 164(1) , pp. 277–285 · doi:10.1002/ijgo.15019 · PMID:37555349 · W4385683864
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This retrospective study evaluated a nerve- and vascular-sparing bowel resection for deep endometriosis, finding a low complication rate and improved gastrointestinal function post-surgery.

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Abstract

OBJECTIVE: Surgical management of bowel endometriosis is still controversial. Recently, many authors have pointed out the potential benefits of preserving the superior rectal artery, thus ensuring better perfusion of the anastomosis. The aim of this study was to evaluate the complication rate and functional outcomes of a bowel resection technique for deep endometriosis (DE) involving a nerve- and vascular-sparing approach. METHODS: A single-center retrospective study was conducted by enrolling patients who underwent segmental resection of the rectus sigmoid for DE in our department between September 2019 and April 2022. Intraoperative and postoperative complications were recorded for each woman, and functional outcomes relating to the pelvic organs were assessed using validated questionnaires (Knowles-Eccersley-Scott-Symptom [KESS] questionnaire and Gastro-Intestinal Quality of Life Index [GIQLI] for bowel function, Bristol Female Lower Urinary Tract Symptoms [BFLUTS] for urinary function, and Female Sexual Function Index [FSFI] for sexual function). These were evaluated preoperatively and postoperatively after 6 months from surgery. RESULTS: Sixty-one patients were enrolled. No patients had Clavien-Dindo grade 3 or 4 complications, there were no rectovaginal fistulas or ureteral lesions, and in no cases was it necessary to reoperate. Temporary bladder voiding deficits were reported in 8.2% of patients, which were treated with self-catheterizations, always resolving within 45 days of surgery. Gastrointestinal function evaluated by KESS and GIQLI improved significantly after surgery, whereas sexual function appeared to worsen, although without reaching the level of statistically significant validity. CONCLUSION: Our vascular- and nerve-sparing segmental bowel resection technique for DE had a low intraoperative and postoperative complication rate and produced an improvement in gastrointestinal function after surgery.

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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

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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