[Gastrointestinal quality of life after low segmental rectal resection for bowel endometriosis]

Introduction: Due to bowel endometriosis itself or its surgical management, various gastrointestinal symptoms can occur. One factor predisposing to the development of postoperative complaints may be low segmental rectal resection. Objective: To assess the quality of life of patients who underwent low rectal resection. Method: We followed 10 patients for 24 months whose anastomosis was created within 8 cm of the anal verge during segmental bowel resection. Questionnaires were administered at predefined time points (preoperatively and at 3, 6, 12, and 24 months postoperatively). Quality of life was evaluated using the Low Anterior Resection Syndrome (LARS) and Bowel Endometriosis Syndrome (BENS) questionnaires. Results: LARS scores were the highest at 3 months postoperatively, followed by an improvement in half of the study population by month 24. At the end of the follow-up period, minor LARS was present in 3 patients (30%), and major LARS was observed in only 1 patient (10%). Minor BENS was already present preoperatively in 5 patients (50%); however, by the end of the study period, it persisted in only 1 patient (10%). We found a significant improvement in BENS symptoms during the follow-up period (p = 0.037). Discussion: Preoperative bowel dysfunction has a multifactorial origin. Anatomical and functional alterations resulting from bowel endometriosis may be underlying factors. Bowel resection performed for endometriosis, particularly low segmental resection, may lead to a decline in postoperative gastrointestinal quality of life. However, symptoms may improve spontaneously over longer-term follow-up. Conclusion: Patients undergoing low rectal resection represent a high-risk group for the development of postoperative gastrointestinal disorders. Orv Hetil. 2026; 167(13): 517–525. Bevezetés: A bélérintettséggel járó endometriosis, illetve annak sebészi megoldása is változatos gastrointestinalis tüneteket okozhat. A posztoperatív panaszok kialakulására hajlamosító tényező lehet az alacsonyan végzett szegmentális rectumresectio. Célkitűzés: Alacsony rectumresectión átesett pácienseink életminőségének vizsgálata. Módszer: Vizsgálatunkban annak a 10 betegnek a 24 hónapos utánkövetését végeztük, akiknél a szegmentális bélresectio során az anastomosis az anustól számított 8 cm-en belül került kialakításra. Megfigyelésünk során előre meghatározott időpontokban (preoperatívan, posztoperatívan a 3., 6., 12. és 24. hónapban) kérdőívek felvételét végeztük. A betegek életminőségének vizsgálatát a LARS (alsó anterior resectiós szindróma) és a BENS (bélendometriosis-szindróma) kérdőívek segítségével rögzítettük. Eredmények: A betegek LARS-pontszáma a posztoperatív 3. hónapban volt a legmagasabb, majd 5 betegnél (50%) fokozatos javuló tendenciát mutatott a 24. hónapra. Az utánkövetési időszak végére enyhe LARS 3 (30%), súlyos LARS csak 1 betegnél volt jelen (10%). 5 betegnél (50%) preoperatívan is fennált enyhe fokú BENS, a vizsgálati idő végére azonban 1 beteg (10%) kivételével senkinél sem volt kimutatható. A megfigyelési időszak alatt a BENS-tünetek szignifikáns javulását észleltük (p = 0,037). Megbeszélés: A preoperatívan is fennálló bélrendszeri diszfunkció oka multifaktoriális, hátterében a bélendometriosisból adódó anatómiai és funkcionális eltérések állhatnak. Az endometriosis indikációjával végzett bélresectio, különösen az alacsony szegmentális resectio, a posztoperatív gastrointestinalis életminőség romlásához vezethet. Ugyanakkor hosszabb utánkövetés során a tünetekben spontán javulás észlelhető. Következtetés: Az alacsony rectumresectión átesett betegek nagy rizikójú csoportot alkotnak a műtét utáni bélfunkciós panaszok kialakulása szempontjából. Orv Hetil. 2026; 167(13): 517–525. - 1 Heinz-Partington S, Costa W, Martins WP, et al. 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