O-059 Gastrointestinal function outcomes of women undergoing nerve-vessel sparing segmental or full-thickness discoid resection for deep colorectal endometriosis

Abstract Study question I there a difference between the gastrointestinal functional outcomes of patients who underwent nerve- vessel-sparing segmental resection (NVSSR) or full-thickness discoid resection(FTDR) for colorectal DE Summary answer Compared to presurgical values, long-term GI function reflected by LARS-scores remains improved following NVSSR, whereas it remains unchanged following FTDR. What is known already Patients undergoing colorectal surgery for symptomatic deep endometriosis(DE) may experience postoperative impairment of gastrointestinal (GI) function. However,there is limited information on long-term follow up of this surgical sequela. Study design, size, duration This prospective study included patients who either underwentnerve- vessel-sparing segmental resection (NVSSR) or full-thickness discoid resection(FTDR) for symptomatic colorectal DE from April 2017 to May 2022 at two tertiary referralcenters. As published previously, GI function was evaluated by LARS and GIQLI scores pre-and postsurgically (postoperative visit 1) and were now re-evaluated (postoperative visit 2) togain information on long-term outcomes. Participants/materials, setting, methods Out of 121 patients, 92 were eligible for the final analysis at postoperative visit 2.The mean follow-up interval was 58.5±17.9 months in the NVSSR group and 61.6±10.7months in the FTDR group. As published previously, GI function was evaluated by LARS and GIQLI scores pre-and postsurgically (postoperative visit 1) and were now re-evaluated (postoperative visit 2) togain information on long-term outcomes. Main results and the role of chance Compared to preoperative LARS scores, patients in the NVSSR-group showed a significant reduction of LARS scores at long term postoperative visit 2(p = 0.001), with LARS scores remaining stable over postoperative visit 1 and visit 2(p = 0.09) at 5 years postoperatively. In women following FTDR, presurgical and long-term postoperative visit 2 LARS scores remained statistically unchanged (p = 0.73), with worsening of LARS scores between postoperative visit 1 and visit 2 (p = 0.02). In contrast, significant improvement of GIQLI was observed between the preoperative visit and postoperative visit 2at five years follow up in both, NVSSR and FTDR groups (p = 0.001 and p = 0.001, respectively). Limitations, reasons for caution The utilization of PROMs such as LARS may yield different results in certain subgroups and should be interpreted with caution. Wider implications of the findings Gastrointestinal function, as indicated by GIQLI scores remains permanently improved following conservative or radical surgery for symptomatic colorectal DE at a mean long-termfollow-up of five years. Trial registration number No